Dysphagia can have severe consequences for the patient's health, influencing health-related quality of life (HRQoL). Sound psychometric properties of HRQoL questionnaires are a precondition for assessing the impact of dysphagia, the focus of this study, resulting in recommendations for the appropriate use of these questionnaires in both clinical practice and research contexts. We performed a systematic review starting with a search for and retrieval of all full-text articles on the development of HRQoL questionnaires related to oropharyngeal dysphagia and/or their psychometric validation from the electronic databases PubMed and Embase published up to June 2011. Psychometric properties were judged according to quality criteria proposed for health status questionnaires. Eight questionnaires were included in this study. Four are aimed solely at HRQoL in oropharyngeal dysphagia: the deglutition handicap index (DHI), dysphagia handicap index (DHI'), M.D. Anderson Dysphagia Inventory (MDADI), and SWAL-QOL, while the EDGQ, EORTC QLQ-STO 22, EORTC QLQ-OG 25 and EORTC QLQ-H&N35 focus on other primary diseases resulting in dysphagia. The psychometric properties of the DHI, DHI', MDADI, and SWAL-QOL were evaluated. For appropriate applicability of HRQoL questionnaires, strong scores on the psychometric criteria face validity, criterion validity, and interpretability are prerequisites. The SWAL-QOL has the strongest ratings for these criteria, while the DHI' is the most easy to apply given its 25 items and the use of a uniform scoring format. For optimal use of HRQoL questionnaires in diverse settings, it is necessary to combine psychometric and utility approaches.

The validity of the OM-6 has been proved in a Dutch population. The data suggest that parents underestimate the seriousness of hearing loss and overestimate the quality of life of their child before surgery, indicating a response shift. Treatment results could lead parents to realize that the situation before surgery had been worse than they thought.

Workplace-Based Assessment (WBA) plays a pivotal role in present-day competency-based medical curricula. Validity in WBA mainly depends on how stakeholders (e.g. clinical supervisors and learners) use the assessments—rather than on the intrinsic qualities of instruments and methods. Current research on assessment in clinical contexts seems to imply that variable behaviours during performance assessment of both assessors and learners may well reflect their respective beliefs and perspectives towards WBA. We therefore performed a Q methodological study to explore perspectives underlying stakeholders’ behaviours in WBA in a postgraduate medical training program. Five different perspectives on performance assessment were extracted: Agency, Mutuality, Objectivity, Adaptivity and Accountability. These perspectives reflect both differences and similarities in stakeholder perceptions and preferences regarding the utility of WBA. In comparing and contrasting the various perspectives, we identified two key areas of disagreement, specifically ‘the locus of regulation of learning’ (i.e., self-regulated versus externally regulated learning) and ‘the extent to which assessment should be standardised’ (i.e., tailored versus standardised assessment). Differing perspectives may variously affect stakeholders’ acceptance, use—and, consequently, the effectiveness—of assessment programmes. Continuous interaction between all stakeholders is essential to monitor, adapt and improve assessment practices and to stimulate the development of a shared mental model. Better understanding of underlying stakeholder perspectives could be an important step in bridging the gap between psychometric and socio-constructivist approaches in WBA.

Background In medical communication research, there has been a shift from ‘communication skills’ towards ‘skilled communication’, the latter implying the development of flexibility and creativity to tailor communication to authentic clinical situations. However, a lack of consensus currently exists what skilled communication entails. This study therefore aims to identify characteristics of a skilled communicator, hereby contributing to theory building in communication research and informing medical training. Method In 2020, six nominal group technique (NGT) sessions were conducted in the context of the general practitioner (GP) training programme engaging 34 stakeholders (i.e. GPs, GP residents, faculty members and researchers) based on their experience and expertise in doctor–patient communication. Participants in each NGT session rank‐ordered a ‘Top 7’ of characteristics of a skilled communicator. The output of the NGT sessions was analysed using mixed methods, including descriptive statistics and thematic content analysis during an iterative process. Results Rankings of the six sessions consisted of 191 items in total, which were organised into 41 clusters. Thematic content analysis of the identified 41 clusters revealed nine themes describing characteristics of a skilled communicator: (A) being sensitive and adapting to the patient; (B) being proficient in applying interpersonal communication; (C) self‐awareness, learning ability and reflective capacity; (D) being genuinely interested; (E) being proficient in applying patient‐centred communication; (F) goal‐oriented communication; (G) being authentic; (H) active listening; and (I) collaborating with the patient. Conclusions We conceptualise a skilled communication approach based on the identified characteristics in the present study to support learning in medical training. In a conceptual model, two parallel processes are key in developing adaptive expertise in communication: (1) being sensitive and adapting communication to the patient and (2) monitoring communication performance in terms of self‐awareness and reflective capacity. The identified characteristics and the conceptual model provide a base to develop a learner‐centred programme, facilitating repeated practice and reflection. Further research should investigate how learners can be optimally supported in becoming skilled communicators during workplace learning.

The Dutch translation of the OM8-30 questionnaire, originally developed in the UK on a large clinical sample, has been applied for validation in an ENT sample, with the aim of assessing otitis media impact and identifying treatment needs in children suffering from chronic otitis media (OM) and/or upper respiratory tract infections (URTI). Caregivers of 246 children completed the OM8-30 and also the generic Strengths and Difficulties Questionnaire (SDQ), prior to otolaryngologist consultation. Factor analysis confirmed the hypothesized six-factor structure, accounting for 55.5% of the variance. The internal consistency was satisfactory to good for all of the physical and developmental facets (alpha-values > or = 0.68). The correlation matrix with the SDQ scales and total difficulties score showed significant relationships for almost all of the OM8-30 developmental facets and sub-aggregate (Ps < 0.01), supporting the concurrent validity of the OM8-30 as a measure of impact in otitis media. This first examination of the Dutch OM8-30 shows that the psychometric characteristics are sufficiently good for the assessment of disease impact, and that this can be subdivided into impact on physical health and on developmental aspects. Recommendations for further research include the study of confounders such as hearing, age and previous operations so that these can be adjusted out, and the determination of which subgroup of children may benefit from tympanostomy tubes.