Document Detail


Reliability of consultation skills assessments using standardised versus real patients.
MedLine Citation:
PMID:  21564197     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Training in and assessment of consultation skills are high on the agenda of vocational training institutes for postgraduate training. There is a need to establish valid and reliable instruments to assess consultation skills in authentic settings. We investigated the number of assessors and observations needed to achieve reliable assessments of the consultation skills of general practice trainees (GPTs) using a communication instrument (MAAS-Global) and either standardised patient (SP) encounters or videotaped real patient (RP) encounters.
METHODS: Eight teachers at the Vrije Universiteit (VU) University Medical Centre in Amsterdam attended a training course on the use of the MAAS-Global instrument, which they subsequently used to assess the consultation skills of 53 GPTs in 176 videotaped consultations (102 with SPs, 74 with RPs). All consultations were randomly allocated and assessed by two teachers independently. The reliability of the ratings was estimated using generalisability theory.
RESULTS: It was easier to obtain acceptable reliability using RP consultations than SP consultations. Two assessors and five consultations were required to achieve minimal reliability (generalisability coefficient 0.7) with RPs, whereas three assessors and 30 consultations were needed to achieve minimal reliability with SPs.
CONCLUSIONS: Inter-observer and context variability in the assessment of the consultation skills of GPTs remains high. To achieve acceptable levels of reliability, large samples of observations are required in both formats, but, interestingly, RP encounters require a smaller sample than SP encounters.
Authors:
Marcel E Reinders; Annette H Blankenstein; Harm W J van Marwijk; Dirk L Knol; Paul Ram; Henriette E van der Horst; Henrica C W de Vet; Cees P M van der Vleuten
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Publication Detail:
Type:  Journal Article; Validation Studies    
Journal Detail:
Title:  Medical education     Volume:  45     ISSN:  1365-2923     ISO Abbreviation:  Med Educ     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-05-13     Completed Date:  2011-08-24     Revised Date:  2011-09-26    
Medline Journal Info:
Nlm Unique ID:  7605655     Medline TA:  Med Educ     Country:  England    
Other Details:
Languages:  eng     Pagination:  578-84     Citation Subset:  IM    
Copyright Information:
© Blackwell Publishing Ltd 2011.
Affiliation:
EMGO Institute for Health and Care Research, Vrije Universiteit University Medical Centre, Amsterdam, The Netherlands. marcel.reinders@vumc.nl
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MeSH Terms
Descriptor/Qualifier:
Clinical Competence / standards*
Communication
Education, Medical, Graduate / methods*,  standards
Educational Measurement / methods,  standards
Humans
Observer Variation
Patient Simulation*
Physician-Patient Relations
Referral and Consultation / standards*
Statistics as Topic
Videotape Recording / utilization

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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