Plymouth Hospitals NHS Trust, Plymouth, Devon, UK.
Arch Dis Child. 2010 May;95(5):323-9. doi: 10.1136/adc.2008.146191. Epub 2008 Nov 19.
To determine the utility of a novel Paediatric Consultation Assessment Tool (PCAT).
Developed to measure clinicians' communication behaviour with children and their parents/guardian, PCAT was designed according to consensus guidelines and refined at a number of stages. Volunteer clinicians provided videotaped real consultations. Assessors were trained to score communication skills using PCAT, a novel rating scale.
Eight UK paediatric units.
19 paediatricians collected video-recorded material; a second cohort of 17 clinicians rated the videos.
Itemised and aggregated scores were analysed (means and 95% confidence intervals) to determine measurement characteristics and relationship to patient, consultation, clinician and assessor attributes; generalisability coefficient of aggregate score; factor analysis of items; comparison of scores between groups of patients, consultations, clinicians and assessors.
188 complete consultations were analysed (median per doctor = 10). 3 videos marked by any trained assessor are needed to reliably (r>0.8) assess a doctor's triadic consultation skills using PCAT, 4 to assess communication with just children or parents. Performance maps to two factors--"clinical skills" and "communication behaviour"; clinicians score more highly on the former (mean (SD) 95% CI 0.52 (0.075)). There were significant differences in scores for the same skills applied to parent and child, especially between the ages of 2 and 10 years, and for information-sharing rather than relationship-building skills (2-tailed significance <0.001).
The PCAT appears to be reliable, valid and feasible for the assessment of triadic consultation skills by direct observation.
确定一种新的儿科咨询评估工具（PCAT）的效用。
PCAT 旨在衡量临床医生与儿童及其父母/监护人的沟通行为，根据共识指南设计，并在多个阶段进行了改进。志愿者临床医生提供了录像真实咨询。评估员接受了使用 PCAT 进行沟通技能评分的培训，这是一种新的评分量表。
英国 8 个儿科单位。
19 名儿科医生收集了录像材料；第二组 17 名临床医生对视频进行了评分。
对分项和综合评分进行分析（平均值和 95%置信区间），以确定测量特征以及与患者、咨询、临床医生和评估员属性的关系；综合评分的可概括系数；项目的因子分析；患者、咨询、临床医生和评估员组之间的评分比较。
分析了 188 次完整咨询（每位医生的中位数为 10 次）。使用 PCAT 可靠地（r>0.8）评估医生的三方咨询技能，需要任何受过培训的评估员标记 3 个视频，评估仅与儿童或父母的沟通，需要 4 个视频。表现映射到两个因素——“临床技能”和“沟通行为”；临床医生在前者上的评分更高（平均值（SD）95%CI 0.52（0.075））。对相同技能应用于父母和儿童的评分存在显著差异，尤其是在 2 至 10 岁之间，以及信息共享而非关系建立技能方面（双侧显著性<0.001）。
PCAT 似乎可靠、有效且可行，可通过直接观察评估三方咨询技能。
