Ford S, Hall A, Ratcliffe D, Fallowfield L
Department of Oncology, University College London Medical School, Bland Sutton Institute, UK.
Soc Sci Med. 2000 Feb;50(4):553-66. doi: 10.1016/s0277-9536(99)00308-1.
The increase in communication skills training for doctors has led to the need for more effective means of evaluation. Analysis of video and audiotaped consultations using systems of interaction analysis can provide the trainee with in-depth feedback about their communication skills. Most interaction process systems were designed for use in primary care and recent research has questioned the applicability of these systems in medical specialties such as oncology. We describe the development of a new instrument, the Medical Interaction Process System (MIPS) for use in teaching communication skills and empirical research in medical encounters, particularly, between doctors and patients with cancer. A comparison of the MIPS and comparable behaviour categories of another widely used system (the Roter Interaction Analysis System) was made to test convergent validity. Pearson correlation coefficients suggested a good level of concurrence between the two systems. Intercoder reliability tests were carried out between two coders at two separate time periods. Both of these indicated good reliability for the majority of categories. The two major advantages of the MIPS over other coding systems are: (1) the system allows for sequential and parallel coding, thus avoiding major coding conflicts and (2) the design of the coding sheet results in a multidimensional view of the consultation without data loss. We believe that the MIPS yields useful information for teaching doctors communication skills and also provides an objective method for evaluating the effectiveness of communication skills courses.
医生沟通技能培训的增加导致了对更有效评估方法的需求。使用互动分析系统对视频和录音会诊进行分析，可以为受训者提供有关其沟通技能的深入反馈。大多数互动过程系统是为初级保健设计的，最近的研究对这些系统在肿瘤学等医学专科中的适用性提出了质疑。我们描述了一种新工具——医学互动过程系统（MIPS）的开发，该系统用于教授沟通技能以及在医疗会诊中，特别是在医生与癌症患者之间的实证研究。对MIPS与另一个广泛使用的系统（罗特互动分析系统）的可比行为类别进行了比较，以测试收敛效度。皮尔逊相关系数表明这两个系统之间有良好的一致性。在两个不同时间段由两名编码员进行了编码员间信度测试。这两项测试均表明大多数类别具有良好的信度。MIPS相对于其他编码系统的两个主要优点是：（1）该系统允许顺序编码和平行编码，从而避免了主要的编码冲突；（2）编码表的设计可以在不损失数据的情况下提供会诊的多维视图。我们认为，MIPS为教授医生沟通技能提供了有用的信息，也为评估沟通技能课程的有效性提供了一种客观方法。
