Department of Industrial Engineering and Management, Ben-Gurion University of the Negev, Beer-Sheva, Israel ; Department of Industrial Engineering and Management, Ariel University, Ariel, Israel.
Department of Industrial Engineering and Management, Ariel University, Ariel, Israel.
Isr J Health Policy Res. 2015 Feb 23;4:4. doi: 10.1186/2045-4015-4-4. eCollection 2015.
The traditional dyadic dynamics of the medical encounter has been altered into a triadic relationship by introducing the computer into the examination room. This study defines Patient-Doctor-Computer Communication (PDCC) as a new construct and provides an initial validation process of an instrument for assessing PDCC in the computerized exam room: the e-SEGUE.
Based on the existing literature, a new construct, PDCC, is defined as the physician's ability to provide patient-centered care while using the computer during the medical encounter. This study elucidates 27 PDCC-related behaviors from the relevant literature and state of the art models of PDCC. These were embedded in the SEGUE communication assessment framework to form the e-SEGUE, a communication skills assessment tool that integrates computer-related communication skills. Based on Mackenzie et al.'s methodological approach of measurement construction, we conducted a two-phased content validity analysis by a general and expert panels of the PDCC behaviors represented in the e-SEGUE. This study was carried out in an environment where EMR use is universal and fully integrated in the physicians' workflow.
The panels consisted of medical students, residents, primary care physicians, healthcare leaders and faculty of medicine members, who rated and provided input regarding the 27 behaviors. Overall, results show high level of agreement with 23 PDCC-related behaviors.
The PDCC instrument developed in this study, the e-SEGUE, fared well in a rigorous, albeit initial, validation process has a unique potential for training and enhancing patient-doctor communication (PDC) in the computerized examination room pending further development.
通过将计算机引入诊室，传统的医患二元动态关系已转变为三元关系。本研究将医患计算机交流（PDCC）定义为一个新的构念，并提供了一种用于评估计算机化诊室中 PDCC 的工具的初始验证过程：电子 SEGUE。
基于现有文献，将 PDCC 定义为医生在医疗过程中使用计算机时提供以患者为中心的护理的能力。本研究从相关文献和 PDCC 的现有状态模型中阐明了 27 种与 PDCC 相关的行为。这些行为被嵌入 SEGUE 沟通评估框架中，形成了电子 SEGUE，这是一种整合了与计算机相关的沟通技巧的沟通技巧评估工具。根据 Mackenzie 等人的测量构建方法学方法，我们通过电子 SEGUE 中代表的 PDCC 行为的一般和专家小组进行了两阶段的内容有效性分析。本研究是在 EMR 普遍使用且完全集成到医生工作流程中的环境中进行的。
这些小组由医学生、住院医师、初级保健医生、医疗保健领导者和医学教员组成，他们对 27 种行为进行了评分并提供了意见。总体而言，结果显示出对 23 种与 PDCC 相关的行为具有高度共识。
本研究开发的 PDCC 工具，即电子 SEGUE，在严格的、尽管是初步的验证过程中表现良好，具有在计算机化检查室中培训和增强医患沟通（PDC）的独特潜力，有待进一步发展。
