Measuring patient views of physician communication skills: Development and testing of the Communication Assessment Tool

Makoul, Gregory; Krupat, Edward; Chang, Chih Hung

doi:10.1016/j.pec.2007.05.005

Cited by 358 publications

(407 citation statements)

References 17 publications

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“…17 This 15-item survey is written at a fourth grade reading level, and measures responses along a 5-point scale (1 ¼ poor, 2 ¼ fair, 3 ¼ good, 4 ¼ very good, 5 ¼ excellent). The CAT was originally field tested with a convenience sample of 38 physicians from various regions within the US, across 6 specialties (Dermatology, Family Medicine, Neurosurgery, Ophthalmology, Orthopedic Surgery, and Physical Medicine & Rehabilitation).…”

Section: Methodsmentioning

confidence: 99%

“…This method of reporting scores as a percentage of ''excellent'' responses was found to be more useful for summarizing physician scores than reporting mean scores, which are highly skewed towards positive performance. 17 Interviews were conducted by trained research assistants during hospitalists' weekday shifts. Hospitalists were not told which patients would be recruited, but were aware that patients on the service were being interviewed to assess communication.…”

Section: Methodsmentioning

confidence: 99%

“…17 The CAT was initially field tested in outpatient offices, omitting the inpatient experience. A 2008 study 18 successfully adapted the CAT tool for use in assessing emergency department (ED) teams.…”

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confidence: 99%

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Assessing patient perceptions of hospitalist communication skills using the Communication Assessment Tool (CAT)

Ferranti

Makoul

Forth

et al. 2010

Journal of Hospital Medicine

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BACKGROUND:Hospitalists care for an increasing percentage of hospitalized patients, yet evaluations of patient perceptions of hospitalists' communication skills are lacking.OBJECTIVE:Assess hospitalist communication skills using the Communication Assessment Tool (CAT).METHODS:A cross‐sectional study of patients, age 18 or older, admitted to the hospital medicine service at an urban, academic medical center with 873 beds. Thirty‐five hospitalists assigned to both direct care and teaching service were assessed.MEASUREMENTS:Hospitalist communication was measured with the CAT. The 14‐item survey, written at a fourth grade level, measures responses along a 5‐point scale (“poor” to “excellent”). Scores are reported as a percentage of “excellent” responses.RESULTS:We analyzed 700 patient surveys (20 for each of 35 hospitalists). The proportion of excellent ratings for each hospitalist ranged from 38.5% to 73.5%, with an average of 59.1% excellent (SD=9.5). Highest ratings on individual CAT items were for treating the patient with respect, letting the patient talk without interruptions, and talking in terms the patient can understand. Lowest ratings were for involving the patient in decisions as much as he or she wanted, encouraging the patient to ask questions, and greeting the patient in a way that made him or her feel comfortable. Overall scale reliability was high (Cronbach's alpha = 0.97).CONCLUSIONS:The CAT can be used to gauge patient perceptions of hospitalist communication skills. Many hospitalists may benefit from targeted training to improve communication skills, particularly in the areas of encouraging questions and involving patients in decision making. Journal of Hospital Medicine 2010. © 2010 Society of Hospital Medicine.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Assessing patient perceptions of hospitalist communication skills using the Communication Assessment Tool (CAT)

Ferranti

Makoul

Forth

et al. 2010

Journal of Hospital Medicine

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“…Additionally, three instruments were found where respondents assessed an external event [18,72,73], and one instrument related to the primary health care field [74]. Over 400 items were identified, and 122 were retained in the item pool.…”

Section: Resultsmentioning

confidence: 99%

“…Further studies are needed to determine the number of assessments necessary per supervisor in section A and per supervision team in section B for achieving appropriate statistical precision. Comparable instruments recommend from 4 [76] to 20 [72] assessments per evaluatee.…”

Section: Discussionmentioning

confidence: 99%

Development and validation of the ExPRESS instrument for primary health care providers’ evaluation of external supervision

Schriver

Cubaka

Vedsted

et al. 2018

Global Health Action

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Background: External supervision of primary health care facilities to monitor and improve services is common in low-income countries. Currently there are no tools to measure the quality of support in external supervision in these countries. Aim: To develop a provider-reported instrument to assess the support delivered through external supervision in Rwanda and other countries. Methods: “External supervision: Provider Evaluation of Supervisor Support” (ExPRESS) was developed in 18 steps, primarily in Rwanda. Content validity was optimised using systematic search for related instruments, interviews, translations, and relevance assessments by international supervision experts as well as local experts in Nigeria, Kenya, Uganda and Rwanda. Construct validity and reliability were examined in two separate field tests, the first using exploratory factor analysis and a test–retest design, the second for confirmatory factor analysis. Results: We included 16 items in section A (‘The most recent experience with an external supervisor’), and 13 items in section B (‘The overall experience with external supervisors’). Item-content validity index was acceptable. In field test I, test–retest had acceptable kappa values and exploratory factor analysis suggested relevant factors in sections A and B used for model hypotheses. In field test II, models were tested by confirmatory factor analysis fitting a 4-factor model for section A, and a 3-factor model for section B. Conclusions: ExPRESS is a promising tool for evaluation of the quality of support of primary health care providers in external supervision of primary health care facilities in resource-constrained settings. ExPRESS may be used as specific feedback to external supervisors to help identify and address gaps in the supervision they provide. Further studies should determine optimal interpretation of scores and the number of respondents needed per supervisor to obtain precise results, as well as test the functionality of section B.

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Glucose Self-monitoring in Non–Insulin-Treated Patients With Type 2 Diabetes in Primary Care Settings

et al. 2017

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The value of self-monitoring of blood glucose (SMBG) levels in patients with non-insulin-treated type 2 diabetes has been debated. OBJECTIVE To compare 3 approaches of SMBG for effects on hemoglobin A 1c levels and health-related quality of life (HRQOL) among people with non-insulin-treated type 2 diabetes in primary care practice. DESIGN, SETTING, AND PARTICIPANTS The Monitor Trial study was a pragmatic, open-label randomized trial conducted in 15 primary care practices in central North Carolina. Participants were randomized between January 2014 and July 2015. Eligible patients with type 2 non-insulin-treated diabetes were: older than 30 years, established with a primary care physician at a participating practice, had glycemic control (hemoglobin A 1c) levels higher than 6.5% but lower than 9.5% within the 6 months preceding screening, as obtained from the electronic medical record, and willing to comply with the results of random assignment into a study group. Of the 1032 assessed for eligibility, 450 were randomized. INTERVENTIONS No SMBG, once-daily SMBG, and once-daily SMBG with enhanced patient feedback including automatic tailored messages delivered via the meter. MAIN OUTCOMES AND MEASURES Coprimary outcomes included hemoglobin A 1c levels and HRQOL at 52 weeks. RESULTS A total of 450 patients were randomized and 418 (92.9%) completed the final visit. There were no significant differences in hemoglobin A 1c levels across all 3 groups (P = .74; estimated adjusted mean hemoglobin A 1c difference, SMBG with messaging vs no SMBG, −0.09%; 95% CI, −0.31% to 0.14%; SMBG vs no SMBG, −0.05%; 95% CI, −0.27% to 0.17%). There were also no significant differences found in HRQOL. There were no notable differences in key adverse events including hypoglycemia frequency, health care utilization, or insulin initiation. CONCLUSIONS AND RELEVANCE In patients with non-insulin-treated type 2 diabetes, we observed no clinically or statistically significant differences at 1 year in glycemic control or HRQOL between patients who performed SMBG compared with those who did not perform SMBG. The addition of this type of tailored feedback provided through messaging via a meter did not provide any advantage in glycemic control. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT02033499

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Measuring patient views of physician communication skills: Development and testing of the Communication Assessment Tool

Cited by 358 publications

References 17 publications

Assessing patient perceptions of hospitalist communication skills using the Communication Assessment Tool (CAT)

Assessing patient perceptions of hospitalist communication skills using the Communication Assessment Tool (CAT)

Development and validation of the ExPRESS instrument for primary health care providers’ evaluation of external supervision

Glucose Self-monitoring in Non–Insulin-Treated Patients With Type 2 Diabetes in Primary Care Settings

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