Assessing Communication Skills in Real Medical Encounters in Oncology: Development and Validation of the ComOn-Coaching Rating Scales

Abstract

One of the challenges in research on teaching physician-patient communication is how to assess communication, necessary for evaluating training, the learning process, and for feedback. Few instruments have been validated for real physician-patient consultations. Real consultations involve unique contexts, different persons, and topics, and are difficult to compare. The aim of this study is to develop and validate a rating scale for assessment of such consultations. For the evaluation study of a communication skills training for physicians in oncology, real consultations were recorded in three assessment points. Based on earlier work and on current studies, a new instrument was developed for assessment of these consultations. Two psychologists were trained in using the instrument and assessed 42 consultations. For inter-rater reliability, interclass correlation (ICC) was calculated. The final version of the rating scales consists of 13 items evaluated on a 5-point scale. The items are grouped in seven areas: "Start of conversation," "assessment of the patient's perspective," "structure of conversation," "emotional issues," "end of conversation," "general communication skills," and "overall evaluation." ICC coefficients for the domains ranged from .44 to .77. An overall coefficient of all items resulted in an ICC of .66. The ComOn-Coaching Rating Scales are a short, reliable, and applicable instrument for the assessment of real physician-patient consultations in oncology. If adapted, they could be used in other areas. They were developed for research and teaching purposes and meet the required methodological criteria. Rater training should be considered more deeply by further research.

ComOn-Coaching: The effect of a varied number of coaching sessions on transfer into clinical practice following communication skills training in oncology: Results of a randomized controlled trial

“…Interaction analysis methods are based on the assumption that certain categories of reactions are good, independently from the context of the consultation [ 62 ]. Our study, in contrast, used rating scales, which are less objective but evaluate the performance and appropriateness of the physician’s reactions [ 57 ]. Thus, this study not only replicates the heterogeneous results of the other studies but also expands the discussion to further aspects, such as the structure of consultation and the meaning of the context.…”

“…Third, our main instrument was not equally reliable in all items, as discussed above [ 57 ]. We addressed this issue by using the rater random effect as a covariate for the calculation of the mixed models.…”

“…Each consultation was evaluated by one of two raters who were blinded to group assignments and assessment points. The raters, two psychologists with experience in consultations with cancer patients, were trained in using the ComOn-Coaching Rating Scales [ 57 ] for both the validation study of the instrument and the present evaluation study. The training consisted of eight sessions of 3-4h each, where recorded consultations were rated and discussed till acceptable agreement levels were achieved.…”

Efficacy of Communication Skills Training of Preclinical Medical Students via Health Literacy Teaching to High School Students: A Pilot Study

“…Selected categories from ComON Check [29][30][31] namely, the starting and ending of a conversation, the structure of a conversation, general communication skills, and overall evaluation of a conversation (Fig 2 ) were evaluated by each medical student, the SP, and the 3 medical instructors. A paired t-test of the pre-and post-assessment scores was performed.…”

Psychometric properties of the Korean version of ComOn coaching for oncology nurses

“…ComOn Coaching was developed to overcome the shortcomings of existing instruments. 21 It focuses on general communication skills and has a rating scale independent of a specific context. It has several advantages: representing key verbal and non-verbal communication skills, enabling quantitative and qualitative assessment, time efficiency, capability of assessing small changes, and acceptable internal consistency and inter–rater reliability.…”