Assessing communication quality of consultations in primary care: initial reliability of the Global Consultation Rating Scale, based on the Calgary-Cambridge Guide to the Medical Interview

Burt, Jenni, Abel, Gary, Elmore, Natasha, Campbell, John, Roland, Martin, Benson, John and Silverman, Jonathan 2014, Assessing communication quality of consultations in primary care: initial reliability of the Global Consultation Rating Scale, based on the Calgary-Cambridge Guide to the Medical Interview, BMJ open, vol. 4, no. 3, doi: 10.1136/bmjopen-2013-004339.

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Title Assessing communication quality of consultations in primary care: initial reliability of the Global Consultation Rating Scale, based on the Calgary-Cambridge Guide to the Medical Interview
Author(s) Burt, Jenni
Abel, Gary
Elmore, Natasha
Campbell, John
Roland, Martin
Benson, John
Silverman, JonathanORCID iD for Silverman, Jonathan orcid.org/0000-0002-1002-1951
Journal name BMJ open
Volume number 4
Issue number 3
Article ID e004339
Total pages 8
Publisher BMJ Publishing
Place of publication London, Eng.
Publication date 2014-03-06
ISSN 2044-6055
Keyword(s) Medical Education & Training
Statistics & Research Methods
Science & Technology
Life Sciences & Biomedicine
Medicine, General & Internal
General & Internal Medicine
PERFORMANCE
COMPETENCE
INSTRUMENT
SKILLS
Summary OBJECTIVES: To investigate initial reliability of the Global Consultation Rating Scale (GCRS: an instrument to assess the effectiveness of communication across an entire doctor-patient consultation, based on the Calgary-Cambridge guide to the medical interview), in simulated patient consultations. DESIGN: Multiple ratings of simulated general practitioner (GP)-patient consultations by trained GP evaluators. SETTING: UK primary care. PARTICIPANTS: 21 GPs and six trained GP evaluators. OUTCOME MEASURES: GCRS score. METHODS: 6 GP raters used GCRS to rate randomly assigned video recordings of GP consultations with simulated patients. Each of the 42 consultations was rated separately by four raters. We considered whether a fixed difference between scores had the same meaning at all levels of performance. We then examined the reliability of GCRS using mixed linear regression models. We augmented our regression model to also examine whether there were systematic biases between the scores given by different raters and to look for possible order effects. RESULTS: Assessing the communication quality of individual consultations, GCRS achieved a reliability of 0.73 (95% CI 0.44 to 0.79) for two raters, 0.80 (0.54 to 0.85) for three and 0.85 (0.61 to 0.88) for four. We found an average difference of 1.65 (on a 0-10 scale) in the scores given by the least and most generous raters: adjusting for this evaluator bias increased reliability to 0.78 (0.53 to 0.83) for two raters; 0.85 (0.63 to 0.88) for three and 0.88 (0.69 to 0.91) for four. There were considerable order effects, with later consultations (after 15-20 ratings) receiving, on average, scores more than one point higher on a 0-10 scale. CONCLUSIONS: GCRS shows good reliability with three raters assessing each consultation. We are currently developing the scale further by assessing a large sample of real-world consultations.
Language eng
DOI 10.1136/bmjopen-2013-004339
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2019, BMJ Publishing Group
Persistent URL http://hdl.handle.net/10536/DRO/DU:30119735

Document type: Journal Article
Collections: Faculty of Health
School of Medicine
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