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

Abstract:

OBJECTIVE:To determine the utility of a novel Paediatric Consultation Assessment Tool (PCAT). 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. SETTING:Eight UK paediatric units. PARTICIPANTS:19 paediatricians collected video-recorded material; a second cohort of 17 clinicians rated the videos. 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. 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). CONCLUSIONS:The PCAT appears to be reliable, valid and feasible for the assessment of triadic consultation skills by direct observation.

journal_name

Arch Dis Child

authors

Howells RJ,Davies HA,Silverman JD,Archer JC,Mellon AF

doi

10.1136/adc.2008.146191

subject

Has Abstract

pub_date

2010-05-01 00:00:00

pages

323-9

issue

5

eissn

0003-9888

issn

1468-2044

pii

adc.2008.146191

journal_volume

95

pub_type

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