Radboud Institute of Health Sciences, Dept. Primary and Community Care (161), Radboud University Medical Center, PO Box 9101, 6500, HB, Nijmegen, The Netherlands.
Departement of Medical Psychology, Radboud University Medical Center, PO Box 9101, 6500, HB, Nijmegen, The Netherlands.
BMC Med Educ. 2019 Apr 29;19(1):118. doi: 10.1186/s12909-019-1557-3.
Since patient-centered communication is directly connected to clinical performance, it should be integrated with medical knowledge and clinical skills. Therefore, clinical communication skills should be trained and assessed as an integral part of the student's clinical performance. We were unable to identify a tool, which helps when assessing patient-centered communication skills as an integrated component of medical history taking ('the integrated medical interview'). Therefore, we decided to design a new tailor-made assessment tool, the BOCC (BeOordeling Communicatie en Consultvoering (Dutch), Assessment of Communication and Consultation (English) to help raters assess students' integrated clinical communication skills with the emphasis on patient-centred communication combined with the correct medical content. This is a first initiative to develop such a tool, and this paper describes the first steps in this process.
We investigated the tool in a group of third-year medical students (n = 672) interviewing simulated patients. Internal structure and internal consistency were assessed. Regression analysis was conducted to investigate the relationship between scores on the instrument and general grading. Applicability to another context was tested in a group of fourth-year medical students (n = 374).
PCA showed five components (Communication skills, Problem clarification, Specific History, Problem influence and Integration Skills) with various Cronbach's alpha scores. The component Problem Clarification made the strongest unique contribution to the grade prediction. Applicability was good when investigated in another context.
The BOCC is designed to help raters assess students' integrated communication skills. It was assessed on internal structure and internal consistency. This tool is the first step in the assessment of the integrated medical interview and a basis for further investigation to reform it into a true measurement instrument on clinical communication skills.
由于以患者为中心的沟通直接与临床绩效相关，因此应将其与医学知识和临床技能相结合。因此，临床沟通技巧应作为学生临床绩效的一个组成部分进行培训和评估。我们无法确定一种工具，可以在评估作为病史采集的综合组成部分的以患者为中心的沟通技巧时提供帮助（“综合医学访谈”）。因此，我们决定设计一种新的定制评估工具，即 BOCC（荷兰语中的 BeOordeling Communicatie en Consultvoering，英语中的 Assessment of Communication and Consultation），以帮助评估者评估学生的综合临床沟通技巧，重点是关注患者的沟通技巧与正确的医学内容相结合。这是开发此类工具的首次尝试，本文介绍了该过程的第一步。
我们在一组三年级医学生（n=672）中对模拟患者进行了访谈，对该工具进行了研究。评估了内部结构和内部一致性。进行回归分析以调查仪器得分与总体评分之间的关系。在另一组四年级医学生（n=374）中测试了其适用性。
主成分分析显示，有五个组成部分（沟通技巧、问题澄清、特定病史、问题影响和综合技能），具有不同的 Cronbach's alpha 得分。问题澄清这一组成部分对成绩预测的贡献最大。在另一种情况下进行调查时，适用性良好。
BOCC 旨在帮助评估者评估学生的综合沟通技巧。评估了其内部结构和内部一致性。该工具是评估综合医学访谈的第一步，也是进一步研究将其改造成真正的临床沟通技能测量工具的基础。
