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Assessment of doctors' consultation skills in the paediatric setting: the Paediatric Consultation Assessment Tool.

Authors :
Howells RJ
Davies HA
Silverman JD
Archer JC
Mellon AF
Source :
Archives of disease in childhood [Arch Dis Child] 2010 May; Vol. 95 (5), pp. 323-9. Date of Electronic Publication: 2008 Nov 19.
Publication Year :
2010

Abstract

Objective: To determine the utility of a novel Paediatric Consultation Assessment Tool (PCAT).<br />Design: Developed to measure clinicians' communication behaviour with children and their parents/guardian, PCAT was designed according to consensus guidelines and refined at a number of stages. Volunteer clinicians provided videotaped real consultations. Assessors were trained to score communication skills using PCAT, a novel rating scale.<br />Setting: Eight UK paediatric units.<br />Participants: 19 paediatricians collected video-recorded material; a second cohort of 17 clinicians rated the videos.<br />Main Outcome Measures: Itemised and aggregated scores were analysed (means and 95% confidence intervals) to determine measurement characteristics and relationship to patient, consultation, clinician and assessor attributes; generalisability coefficient of aggregate score; factor analysis of items; comparison of scores between groups of patients, consultations, clinicians and assessors.<br />Results: 188 complete consultations were analysed (median per doctor = 10). 3 videos marked by any trained assessor are needed to reliably (r>0.8) assess a doctor's triadic consultation skills using PCAT, 4 to assess communication with just children or parents. Performance maps to two factors--"clinical skills" and "communication behaviour"; clinicians score more highly on the former (mean (SD) 95% CI 0.52 (0.075)). There were significant differences in scores for the same skills applied to parent and child, especially between the ages of 2 and 10 years, and for information-sharing rather than relationship-building skills (2-tailed significance <0.001).<br />Conclusions: The PCAT appears to be reliable, valid and feasible for the assessment of triadic consultation skills by direct observation.

Details

Language :
English
ISSN :
1468-2044
Volume :
95
Issue :
5
Database :
MEDLINE
Journal :
Archives of disease in childhood
Publication Type :
Academic Journal
Accession number :
19019880
Full Text :
https://doi.org/10.1136/adc.2008.146191