Medical Education, University of Washington, Seattle, Washington, USA.
Teach Learn Med. 2011 Jan;23(1):68-77. doi: 10.1080/10401334.2011.536896.
Multiple-choice exams are not well suited for assessing communication skills. Standardized patient assessments are costly and patient and peer assessments are often biased. Web-based assessment using video content offers the possibility of reliable, valid, and cost-efficient means for measuring complex communication skills, including interprofessional communication.
We report development of the Web-based Team-Oriented Medical Error Communication Assessment Tool, which uses videotaped cases for assessing skills in error disclosure and team communication. Steps in development included (a) defining communication behaviors, (b) creating scenarios, (c) developing scripts, (d) filming video with professional actors, and (e) writing assessment questions targeting team communication during planning and error disclosure.
Using valid data from 78 participants in the intervention group, coefficient alpha estimates of internal consistency were calculated based on the Likert-scale questions and ranged from α=.79 to α=.89 for each set of 7 Likert-type discussion/planning items and from α=.70 to α=.86 for each set of 8 Likert-type disclosure items. The preliminary test-retest Pearson correlation based on the scores of the intervention group was r=.59 for discussion/planning and r=.25 for error disclosure sections, respectively. Content validity was established through reliance on empirically driven published principles of effective disclosure as well as integration of expert views across all aspects of the development process. In addition, data from 122 medicine and surgical physicians and nurses showed high ratings for video quality (4.3 of 5.0), acting (4.3), and case content (4.5).
Web assessment of communication skills appears promising. Physicians and nurses across specialties respond favorably to the tool.
多项选择题考试并不适合评估沟通技巧。标准化患者评估成本高，患者和同伴评估往往存在偏差。基于网络的视频内容评估为可靠、有效和具有成本效益的方式提供了可能，可用于测量包括跨专业沟通在内的复杂沟通技巧。
我们报告了基于网络的团队导向医疗错误沟通评估工具的开发，该工具使用录像病例评估错误披露和团队沟通技能。开发步骤包括：(a)定义沟通行为；(b)创建场景；(c)编写剧本；(d)用专业演员拍摄视频；(e)针对团队沟通和错误披露编写评估问题。
使用干预组 78 名参与者的有效数据，根据 Likert 量表问题计算了内部一致性的系数 alpha 估计值，7 个 Likert 型讨论/计划项目的每组和 8 个 Likert 型披露项目的每组的范围分别为α=.79 到α=.89 和α=.70 到α=.86。干预组基于分数的初步测试-重测 Pearson 相关系数分别为讨论/计划部分 r=.59 和错误披露部分 r=.25。内容效度通过依赖有效披露的经验驱动原则以及在开发过程的所有方面整合专家意见来建立。此外，来自 122 名内科和外科医生和护士的数据对视频质量（5 分制 4.3 分）、表演（4.3 分）和案例内容（4.5 分）的评价较高。
基于网络的沟通技能评估似乎很有前途。跨专业的医生和护士对该工具的反应良好。
