Department of Family and Emergency Medicine, Faculty of Medicine, Laval University, Pavillon Ferdinand-Vandry, Bureau 2881-D, (Québec), Québec, G1V 0A6, Canada.
Department of Family and Emergency Medicine, Faculty of Medicine, Laval University, Pavillon Ferdinand-Vandry, Bureau 2207-A, (Québec), Québec, G1V 0A6, Canada.
BMC Med Educ. 2017 Oct 26;17(1):189. doi: 10.1186/s12909-017-1026-9.
Medical students on clinical rotations have to be assessed on several competencies at the end of each clinical rotation, pointing to the need for short, reliable, and valid assessment instruments of each competency. Doctor patient communication is a central competency targeted by medical schools however, there are no published short (i.e. less than 10 items), reliable and valid instruments to assess doctor-patient communication competency. The Faculty of Medicine of Laval University recently developed a 5-item Doctor-Patient Communication Competency instrument for Medical Students (DPCC-MS), based on the Patient Centered Clinical Method conceptual framework, which provides a global summative end-of-rotation assessment of doctor-patient communication. We conducted a psychometric validation of this instrument and present validity evidence based on the response process, internal structure and relation to other variables using two years of assessment data.
We conducted the study in two phases. In phase 1, we drew on 4991 student DPCC-MS assessments (two years). We conducted descriptive statistics, a confirmatory factor analysis (CFA), and tested the correlation between the DPCC-MS and the Multiple Mini Interviews (MMI) scores. In phase 2, eleven clinical teachers assessed the performance of 35 medical students in an objective structured clinical examination station using the DPCC-MS, a 15-item instrument developed by Côté et al. (published in 2001), and a 2-item global assessment. We compared the DPCC-MS to the longer Côté et al. instrument based on internal consistency, coefficient of variation, convergent validity, and inter-rater reliability.
Phase 1: Cronbach's alpha was acceptable (.75 and .83). Inter-item correlations were positive and the discrimination index was above .30 for all items. CFA supported a unidimensional structure. DPCC-MS and MMI scores were correlated. Phase 2: The DPCC-MS and the Côté et al. instrument had similar internal consistency and convergent validity, but the DPCC-MS had better inter-rater reliability (mean ICC = .61).
The DPCC-MS provides an internally consistent and valid assessment of medical students' communication with patients.
医学生在临床轮转结束时需要对多项能力进行评估，这表明需要有简短、可靠且有效的评估工具来评估每项能力。医患沟通是医学院的核心能力，但目前尚无已发表的简短（即少于 10 项）、可靠且有效的评估医患沟通能力的工具。拉瓦尔大学医学院最近基于以患者为中心的临床方法概念框架，开发了一种 5 项医患沟通能力评估量表（DPCC-MS），用于对医学生进行整体轮转结束时的评估。我们使用两年的评估数据，通过反应过程、内部结构和与其他变量的关系，对该工具进行了心理测量学验证，并提供了有效性证据。
我们分两个阶段进行了这项研究。在第一阶段，我们对 4991 名学生的 DPCC-MS 评估（两年）进行了描述性统计、验证性因素分析（CFA），并测试了 DPCC-MS 与多项迷你面试（MMI）分数之间的相关性。在第二阶段，11 名临床教师使用 DPCC-MS、Côté 等人开发的 15 项工具（发表于 2001 年）和 2 项整体评估对 35 名医学生在客观结构化临床考试站的表现进行了评估。我们根据内部一致性、变异系数、收敛有效性和评分者间信度，比较了 DPCC-MS 与较长的 Côté 等人的工具。
第一阶段：克朗巴赫的阿尔法系数为可接受的（.75 和.83）。项目间相关性为正，所有项目的鉴别指数均高于.30。CFA 支持单维结构。DPCC-MS 和 MMI 分数相关。第二阶段：DPCC-MS 和 Côté 等人的工具具有相似的内部一致性和收敛有效性，但 DPCC-MS 的评分者间信度更好（平均 ICC=0.61）。
DPCC-MS 可对医学生与患者的沟通进行内部一致且有效的评估。
