Background: The aim of the study was to confirm the validity and reliability of the Observation Scheme-12, a measurement tool for rating clinical communication skills. Methods: The study is a sub-study of an intervention study using audio recordings to assess the outcome of communication skills training. This paper describes the methods used to validate the assessment tool Observation Scheme-12 by operationalizing the crude 5-point scale into specific elements described in a codebook. Reliability was tested by calculating the intraclass correlation coefficients for interrater and intrarater reliability. Results: The validation of the Observation Scheme-12 produced a rating tool with 12 items. Each item has 0 to 5 described micro-skills. For each item, the codebook described the criteria for delivering a rating from 0 to 4 depending on how successful the different micro-skills (or number of used jargon words) was accomplished. Testing reliability for the overall score intraclass correlation coefficients was 0.74 for interrater reliability and 0.86 for intrarater reliability. An intraclass correlation coefficient greater than 0.5 was observed for 10 of 12 items. Conclusion: The development of a codebook as a supplement to the assessment tool Observation Scheme-12 enables an objective rating of audiotaped clinical communication with acceptable reliability. The Observation Scheme-12 can be used to assess communication skills based on the Calgary-Cambridge Guide.

Communication between patients and health care providers is a key component for an effective health care system, and patients are increasingly asking for individualized and personalized care and treatment. 1 Providing patient-centered care and treatment requires a fundamental knowledge of the patient, not only learning about biomedical aspects but also about the person behind the disease. 2,3 Consequently, patientcentered communication is required to elicit a patient's experiences, needs, values, and preferences. 4 Patient-centered communication is defined differently by experts, 4,5 but the central idea is that treatment and care depends on knowing the patient as a person. 6 The core elements of this approach to patient care are characterized by addressing the patient's perspective, understanding the patient's psychosocial context, and agreement on a shared plan for treatment and care. 7 Studies have shown associations between patientcentered communication and positive health outcomes, 7-10 increased patient satisfaction, 11,12 reduced medical expenditures, 13,14 and prevention of malpractice litigation. 15,16 Previous research has demonstrated that patient-centered communication can be learned through communication skills training, 17,18 that it improves health care provider (HCP) self-efficacy in patientcentered communication, 19 and patients' perception of PurposeWe hypothesized that health care providers would behave in a more patient-centered manner after the implementation of communication skills training, without causing the consultation to last longer. MethodsThis study was part of the large-scale implementation of a communication skills training program called "Clear-Cut Communication With Patients" at Lillebaelt Hospital in Denmark. Audio recordings from real-life consultations were collected in a pre-post design, with health care providers' participation in communication skills training as the intervention. The training was based on the Calgary-Cambridge Guide, and audio recordings were rated using the Observation Scheme-12. ResultsHealth care providers improved their communication behavior in favor of being more patient-centered.Results were tested using a mixed-effect model and showed significant differences between pre-and postintervention assessments, with a coefficient of 1.3 (95% Cl: 0.35-2.3; P=0.01) for the overall score. The consultations did not last longer after the training. ConclusionsHealth care providers improved their communication in patient consultations after the implementation of a large-scale patient-centered communication skills training program based on the Calgary-Cambridge Guide. This did not affect the length of the consultations.

Objective To translate and cultural adapt the 14-item Communication Assessment Tool (CAT) into Norwegian and Danish, making them as similar as possible. Design This was a translation and validation study including individual interviews for content and face validity and a patient survey for internal consistency and floor-ceiling effect. Setting Outpatient clinic at the Department of Internal Medicine, Lillebaelt Hospital, Denmark and a Norwegian general practice. Participants Ten patients were included for individual interviews and 440 participants completed the survey. Main Outcome Measure Translation and validation of the CAT. Results Despite minor differences in the use of words in the translated versions of CAT, the final versions were very similar. Based on the content and face validation and after agreement with the developers, it was decided to include a ‘non-applicable’ answering option, not a part of the original version. The use of ‘non-applicable’ for each item ranged from 0% to 30% in Norway and from 0% to 6.1% in Denmark. The overall CAT score, i.e. items rated excellent, were 55.5% in Norway and 50.3% in Denmark. For each item, the CAT score ranged between 31.3% and 69.8% in Norway and 33.7% and 57.4% in Denmark. Conclusion The translated and validated CAT can be used to measure patients’ perspectives on clinicians’ communication skills in Denmark and Norway.

Although further studies are warranted for further clarification, our preliminary data substantiate that FDG PET/CT is a viable modality for assessing VTE, at least for DVT. We believe our results add positively to the limited data on this subject and are promising enough to warrant further larger series.