How do trained raters take context factors into account when assessing GP trainee communication performance? An exploratory, qualitative study

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• 作者：Geurt Essers (1) (2)
  Patrick Dielissen (2)
  Chris van Weel (2) (3)
  Cees van der Vleuten (2) (4) (5) (6)
  Sandra van Dulmen (2) (7) (8)
  Anneke Kramer (2)
  
  1. Department of Public Health and Primary Care ; Leiden University Medical Centre ; Hippocratespad 21 ; 2333 ZP ; Leiden ; The Netherlands
  2. Department of Primary and Community Care ; Radboud University Medical Centre ; Nijmegen ; The Netherlands
  3. Australian Primary Health Care Research Institute ; Australian National University ; Canberra ; Australia
  4. Department of Educational Development and Research ; Maastricht University ; Maastricht ; The Netherlands
  5. Northumbria University ; Newcastle upon Tyne ; UK
  6. Copenhagen University ; Copenhagen ; Denmark
  7. NIVEL (Netherlands Institute for Health Services Research) ; Utrecht ; The Netherlands
  8. Department of Health Science ; Buskerud University College ; Drammen ; Norway
  
• 关键词：Communication ; Context ; Assessment ; General practice
• 刊名：Advances in Health Sciences Education
• 出版年：2015
• 出版时间：March 2015
• 年：2015
• 卷：20
• 期：1
• 页码：131-147
• 全文大小：215 KB
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• 刊物类别：Humanities, Social Sciences and Law
• 刊物主题：Education
  Medical Education
  
• 出版者：Springer Netherlands
• ISSN：1573-1677

文摘

Communication assessment in real-life consultations is a complex task. Generic assessment instruments help but may also have disadvantages. The generic nature of the skills being assessed does not provide indications for context-specific behaviour required in practice situations; context influences are mostly taken into account implicitly. Our research questions are: 1. What factors do trained raters observe when rating workplace communication? 2. How do they take context factors into account when rating communication performance with a generic rating instrument? Nineteen general practitioners (GPs), trained in communication assessment with a generic rating instrument (the MAAS-Global), participated in a think-aloud protocol reflecting concurrent thought processes while assessing videotaped real-life consultations. They were subsequently interviewed to answer questions explicitly asking them to comment on the influence of predefined contextual factors on the assessment process. Results from both data sources were analysed. We used a grounded theory approach to untangle the influence of context factors on GP communication and on communication assessment. Both from the think-aloud procedure and from the interviews we identified various context factors influencing communication, which were categorised into doctor-related (17), patient-related (13), consultation-related (18), and education-related factors (18). Participants had different views and practices on how to incorporate context factors into the GP(-trainee) communication assessment. Raters acknowledge that context factors may affect communication in GP consultations, but struggle with how to take contextual influences into account when assessing communication performance in an educational context. To assess practice situations, raters need extra guidance on how to handle specific contextual factors.