Rocha Sheyla Ribeiro, Romão Gustavo Salata, Setúbal Maria Sílvia Velutini, Lajos Giuliane Jesus, Luz Adriana Gomes, Collares Carlos Fernando, Amaral Eliana
Department of Medicine, Federal University of São Carlos, São Carlos, Brazil.
Department of Medicine, University of Ribeirão Preto, Ribeirão Preto, Brazil.
Teach Learn Med. 2020 Jun-Jul;32(3):308-318. doi: 10.1080/10401334.2020.1717958. Epub 2020 Feb 24.
The Communication Assessment Tool (CAT) is a 14-item instrument developed in English to assess medical trainees' interpersonal communication skills from the patient's perspective in clinical settings. Using validated instruments and simulated patients constitutes good practice in assessing doctor-patient communication. The CAT was designed for use in real practice, but has not yet been applied to assessing OB-GYN residents' delivery of bad news in Objective Structured Clinical Examination (OSCE) stations. This study aims to provide validity evidence for using the CAT to assess residents' interpersonal communication skills under difficult circumstances in a simulated clinical setting in Brazil. : Cross-cultural adaptation comprised translation into Portuguese, synthesis of translations, and back-translation. Next, a committee of 10 external and independent experts rated the items for linguistic equivalence and relevance to the overall scale. Researchers used the expert ratings to produce a preliminary Brazilian-Portuguese version. This version was applied by four simulated patients to assess 28 OB-GYN residents completing two, 10-minute OSCE stations focused on delivering bad news. Item and scale content validity indices and internal-consistency reliability were calculated. Simulated patients were interviewed to clarify any doubt regarding the content and usability of the tool and their response process. Thirteen of the 14 items in the Brazilian-Portuguese version were considered "equivalent" by at least 70% of the experts. All items were considered relevant by 100% of the experts. The Item Content Validity Index ranged from .9 to 1, and the Scale Content Validity Index was .99. The instrument showed good reliability for both scenarios (Cronbach's alpha > .90). Simulated patients considered the CAT easy to understand and complete. This study provides validity evidence for using the Brazilian-Portuguese CAT in a simulated clinical environment to assess OB-GYN residents' delivery of bad news. Based on this study's findings, the OB-GYN Department organized an annual formative assessment for residents to improve their interpersonal communication skills. This version of the CAT may also be applicable to other specialties.
沟通评估工具（CAT）是一个由14个项目组成的工具，它以英文开发，用于从患者角度评估医学实习生在临床环境中的人际沟通技巧。使用经过验证的工具和模拟患者是评估医患沟通的良好做法。CAT设计用于实际临床实践，但尚未应用于评估妇产科住院医师在客观结构化临床考试（OSCE）站中传达坏消息的情况。本研究旨在为在巴西模拟临床环境中的困难情况下使用CAT评估住院医师的人际沟通技巧提供效度证据。跨文化适应包括翻译成葡萄牙语、翻译合成以及回译。接下来，由10名外部独立专家组成的委员会对项目进行语言等效性和与总体量表相关性的评分。研究人员利用专家评分生成了巴西葡萄牙语初步版本。该版本由4名模拟患者应用于评估28名完成两个10分钟专注于传达坏消息的OSCE站的妇产科住院医师。计算了项目和量表的内容效度指数以及内部一致性信度。对模拟患者进行访谈以澄清关于该工具的内容、可用性及其反应过程的任何疑问。巴西葡萄牙语版本的14个项目中有13个被至少70%的专家认为是“等效的”。所有项目都被100%的专家认为是相关的。项目内容效度指数范围为0.9至1，量表内容效度指数为0.99。该工具在两种情况下都显示出良好的信度（克朗巴哈系数>0.90）。模拟患者认为CAT易于理解和完成。本研究为在模拟临床环境中使用巴西葡萄牙语版CAT评估妇产科住院医师传达坏消息的情况提供了效度证据。基于本研究结果，妇产科部门为住院医师组织了年度形成性评估以提高他们的人际沟通技巧。这个版本的CAT也可能适用于其他专业。
