University Hospital Freiburg, Department of Internal Medicine I, Freiburg, Germany.
J Eval Clin Pract. 2012 Apr;18(2):225-30. doi: 10.1111/j.1365-2753.2010.01556.x. Epub 2010 Oct 4.
Communication skills training (CST) has to be proven effective, and therefore reliable instruments to evaluate CST are required. Most instruments assessing medical consultations do not take individual aspects of CST into consideration. Such assessment tools should naturally also be closely associated with the communication skills taught to the participants. Thus, we developed a new instrument which evaluates the effects of specific CST.
Based on a literature review, we developed a checklist with questions ('items') which assess the behaviour of a doctor in a special doctor-patient consultation (The COM-ON-Checklist, COM-ON = communication in oncology). First, we developed items for general communication skills that are a requirement of every doctor-patient consultation, and in addition to this, we developed items for specific situations which present a particular challenge for doctors in terms of communication skills, namely: the situation in which the doctor is required to discuss the shift from curative to palliative care, and the disclosure of information about clinical trials. For assessment, a 5-point rating scale with anchor points was used.
Blinded raters were trained to use the COM-ON-Checklist. The intra-class correlation (ICC) was used to calculate the agreement between raters.
The COM-ON-Checklist consists of two parts: the first part evaluates general communication skills; the second part evaluates content-specific aspects of the consultation. The ICC ranged from 0.5 to 0.8, which demonstrates moderate to very good results of inter-rater reliability.
The COM-ON-Checklist can be used to evaluate specific CST. It is also a feedback source for clinicians because it assesses their personal communication skills in different settings. In conclusion, the COM-ON-Checklist provides a reliable, structured method for assessing communication skills in oncological settings.
沟通技巧培训（CST）必须被证明是有效的，因此需要可靠的工具来评估 CST。大多数评估医疗咨询的工具都没有考虑 CST 的个别方面。这种评估工具自然也应该与向参与者传授的沟通技巧密切相关。因此，我们开发了一种新的工具来评估特定 CST 的效果。
基于文献回顾，我们开发了一个检查表，其中包含评估医生在特殊医患咨询中行为的问题（COM-ON-Checklist，COM-ON = 肿瘤学中的沟通）。首先，我们开发了一般沟通技巧的项目，这些技巧是每个医患咨询的要求，除此之外，我们还开发了针对特定情况的项目，这些情况对医生的沟通技巧提出了特殊挑战，即：医生需要讨论从治疗转向姑息治疗的情况，以及披露临床试验信息的情况。评估使用了带有锚点的 5 点评分量表。
受过训练的盲评者使用 COM-ON-Checklist 进行评估。使用组内相关系数（ICC）来计算评分者之间的一致性。
COM-ON-Checklist 由两部分组成：第一部分评估一般沟通技巧；第二部分评估咨询的特定内容方面。ICC 范围为 0.5 至 0.8，表明评分者之间的可靠性具有中等至非常好的结果。
COM-ON-Checklist 可用于评估特定的 CST。它也是临床医生的反馈源，因为它评估了他们在不同环境下的个人沟通技巧。总之，COM-ON-Checklist 为评估肿瘤学环境中的沟通技巧提供了一种可靠、结构化的方法。
