Abstract
Construct: 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. Background: 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. Approach: Crosscultural 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. Findings:
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. Conclusions: 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.
Original language | English |
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Pages (from-to) | 308-318 |
Number of pages | 11 |
Journal | Teaching and Learning in Medicine |
Volume | 32 |
Issue number | 3 |
DOIs | |
Publication status | Published - 26 May 2020 |
Keywords
- cross-cultural adaptation
- validation
- communication skill
- medical education
- clinical assessment
- PHYSICIAN-PATIENT COMMUNICATION
- CONSENSUS STATEMENT
- CONTENT VALIDITY
- BAD-NEWS
- SKILLS
- TRANSITION
- IMPACT
- GUIDE
- CARE