Niglio de Figueiredo Marcelo, Krippeit Lorena, Freund Johanna, Ihorst Gabriele, Joos Andreas, Bengel Juergen, Wuensch Alexander
Department of Psychosomatic Medicine and Psychotherapy, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstr. 8, Freiburg, 79104, Germany.
Department of Dermatology and Venereology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstr. 7, Freiburg, 79104, Germany.
J Cancer Educ. 2019 Feb;34(1):73-81. doi: 10.1007/s13187-017-1269-5.
One of the challenges in research on teaching physician-patient communication is how to assess communication, necessary for evaluating training, the learning process, and for feedback. Few instruments have been validated for real physician-patient consultations. Real consultations involve unique contexts, different persons, and topics, and are difficult to compare. The aim of this study is to develop and validate a rating scale for assessment of such consultations. For the evaluation study of a communication skills training for physicians in oncology, real consultations were recorded in three assessment points. Based on earlier work and on current studies, a new instrument was developed for assessment of these consultations. Two psychologists were trained in using the instrument and assessed 42 consultations. For inter-rater reliability, interclass correlation (ICC) was calculated. The final version of the rating scales consists of 13 items evaluated on a 5-point scale. The items are grouped in seven areas: "Start of conversation," "assessment of the patient's perspective," "structure of conversation," "emotional issues," "end of conversation," "general communication skills," and "overall evaluation." ICC coefficients for the domains ranged from .44 to .77. An overall coefficient of all items resulted in an ICC of .66. The ComOn-Coaching Rating Scales are a short, reliable, and applicable instrument for the assessment of real physician-patient consultations in oncology. If adapted, they could be used in other areas. They were developed for research and teaching purposes and meet the required methodological criteria. Rater training should be considered more deeply by further research.
研究医生与患者沟通教学面临的挑战之一是如何评估沟通，这对于评估培训、学习过程以及提供反馈而言是必要的。很少有工具在真实的医患咨询中得到验证。真实的咨询涉及独特的情境、不同的人员和话题，并且难以进行比较。本研究的目的是开发并验证一种用于评估此类咨询的评分量表。为了对肿瘤学医生的沟通技能培训进行评估研究，在三个评估点记录了真实的咨询情况。基于早期的工作和当前的研究，开发了一种新工具用于评估这些咨询。两名心理学家接受了使用该工具的培训，并评估了42次咨询。为了评估评分者间的信度，计算了组内相关系数（ICC）。评分量表的最终版本由13个项目组成，采用5分制进行评估。这些项目分为七个领域：“对话开始”“对患者观点的评估”“对话结构”“情感问题”“对话结束”“一般沟通技巧”和“总体评价”。各领域的ICC系数范围为0.44至0.77。所有项目的总体系数得出ICC为0.66。ComOn-Coaching评分量表是一种简短、可靠且适用的工具，用于评估肿瘤学中真实的医患咨询。如果进行调整，它们可用于其他领域。它们是为研究和教学目的而开发的，符合所需的方法学标准。评分者培训应通过进一步研究进行更深入的考虑。
