Dine C Jessica, Ruffolo Stefanie, Lapin Jennifer, Shea Judy A, Kogan Jennifer R
J Grad Med Educ. 2014 Mar;6(1):71-7. doi: 10.4300/JGME-D-13-00173.1.
Residents receive little information about how they interact with patients.
This pilot study assessed the feasibility and validity of a new 16-item tool developed to assess patients' perspectives of interns' communication skills and professionalism and the team's communication.
Feasibility was determined by the percentage of surveys completed, the average time for survey completion, the percentage of target interns evaluated, and the mean number of evaluations per intern. Generalizability was analyzed using an (evaluator:evaluatee) × item model. Simulated D studies estimated optimal numbers of items and evaluators. Factor analysis with varimax rotation was used to examine the structure of the items. Scores were correlated with other measures of communication and professionalism for validation.
Most patients (225 of 305 [74%]) completed the evaluation. Each survey took approximately 6.3 minutes to complete. In 43 days over 18 weeks, 45 of 50 interns (90%) were evaluated an average of 4.6 times. Fifty evaluations would be required to reach a minimally acceptable coefficient (0.57). Two factor structures were identified. The evaluation did not correlate with faculty evaluations of resident communication but did correlate weakly (r = 0.140, P = .04) with standardized patient evaluations.
A large number of patient evaluations are needed to reliably assess intern and team communication skills. Evaluations by patients add a perspective in assessing these skills that is different from those of faculty evaluations. Future work will focus on whether this new information adds to existing evaluation systems and warrants the added effort.
住院医师很少得到关于他们如何与患者互动的信息。
这项初步研究评估了一种新的包含16个条目的工具的可行性和有效性，该工具旨在评估患者对实习医生沟通技巧和专业素养以及团队沟通的看法。
可行性通过完成的调查问卷百分比、平均完成调查时间、被评估的目标实习医生百分比以及每个实习医生的平均评估次数来确定。使用（评估者：被评估者）×条目模型分析可推广性。模拟D研究估计了条目的最佳数量和评估者数量。采用方差最大化旋转的因子分析来检验条目的结构。为了验证，将分数与其他沟通和专业素养的测量指标进行相关性分析。
大多数患者（305名中的225名[74%]）完成了评估。每份调查问卷大约需要6.3分钟完成。在18周的43天里，50名实习医生中的45名（90%）平均被评估了4.6次。需要50次评估才能达到最低可接受系数（0.57）。识别出两种因子结构。该评估与教员对住院医师沟通的评估不相关，但与标准化患者评估呈弱相关（r = 0.140，P = 0.04）。
需要大量的患者评估才能可靠地评估实习医生和团队的沟通技巧。患者评估在评估这些技巧时提供了一种与教员评估不同的视角。未来的工作将集中于这种新信息是否能补充现有的评估系统以及是否值得付出额外的努力。
