Cox J, Mulholland H
University of Newcastle upon Tyne.
BMJ. 1993 Apr 17;306(6884):1043-6. doi: 10.1136/bmj.306.6884.1043.
To identify those important characteristics of doctors' and patients' behaviour that distinguish between "good" and "bad" consultations when viewed on videotape; to use these characteristics to develop a reliable instrument for assessing general practitioners' performance in their own consultations.
Questionnaires completed by patients, general practitioner trainers, and general practitioner trainees. Reliability of draft instrument tested by general practitioner trainers.
All vocational training schemes for general practice in the Northern region of England.
First stage: 76 patients in seven groups, 108 general practice trainers in 12 groups, and 122 general practice trainees in 10 groups. Second stage: 85 general practice trainers in 12 groups.
Trainers' ratings of importance; alpha coefficients of draft instrument by trainee, group, and consultation.
6890 characteristics of good and bad consultations were consolidated into a draft assessment instrument consisting of 46 pairs of definitions separated by six point bipolar scales. Nine statement pairs given low importance ratings by trainers were eliminated, reducing the instrument to 37 statement pairs. To test reliability, general practitioner trainers used the instrument to assess three consultations. With the exception of one group of trainers, all alpha coefficients exceeded the acceptable level of 0.80.
The instrument produced is reliable for assessing general practitioners' performance in their own consultations.
识别医生和患者行为的重要特征，这些特征在观看录像时能区分“好”与“坏”的会诊；利用这些特征开发一种可靠的工具，用于评估全科医生在其自身会诊中的表现。
患者、全科医生培训师和全科医生实习生填写问卷。由全科医生培训师测试该工具草案的可靠性。
英格兰北部地区所有的全科医学职业培训计划。
第一阶段：7组中的76名患者、12组中的108名全科医生培训师以及10组中的122名全科医生实习生。第二阶段：12组中的85名全科医生培训师。
培训师对重要性的评分；实习生、小组和会诊对工具草案的α系数。
6890个关于好与坏会诊的特征被整合到一个评估工具草案中，该草案由46对定义组成，由六点双极量表分隔。培训师对重要性评分较低的9对陈述被剔除，使该工具减少到37对陈述。为测试可靠性，全科医生培训师使用该工具评估三次会诊。除一组培训师外，所有α系数均超过可接受水平0.80。
所产生的工具对于评估全科医生在其自身会诊中的表现是可靠的。
