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

• Published in: Postgraduate medical journal Vol. 86; no. 1020; pp. 584 - 590
• Main Authors: Howells, R J, Davies, H A, Silverman, J D, Archer, J C, Mellon, A F
• Format: Journal Article
• Language: English
• Published: London The Fellowship of Postgraduate Medicine 01.10.2010; BMJ Publishing Group; Oxford University Press
• Subjects: Biological and medical sciences; Children & youth; Communication; Families & family life; Feedback; General aspects; Health participants; Information sharing; Medical sciences; Public health. Hygiene; Public health. Hygiene-occupational medicine; Ratings & rankings; Tutoring; Validation studies; Validity; Human; Medicine; Pediatrics; Health staff; Consultation; Physician; Paper; Vocational aptitude; Health service; Child; Tool
• ISSN: 0032-5473; 1469-0756
• DOI: 10.1136/pgmj.2008.146191rep

ObjectiveTo determine the utility of a novel Paediatric Consultation Assessment Tool (PCAT).DesignDeveloped 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.SettingEight UK paediatric units.Participants19 paediatricians collected video-recorded material; a second cohort of 17 clinicians rated the videos.Main outcome measuresItemised 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.Results188 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 relationshipbuilding skills (2-tailed significance <0.001).ConclusionsThe PCAT appears to be reliable, valid and feasible for the assessment of triadic consultation skills by direct observation.