住院医师“四情境”医患沟通技能教师评价量表编制

The Development of a“Four-Situation”Scale for Assessing Residents’Doctor-Patient Communication Skills by Lead Teachers

目的:编制住院医师“四情境”医患沟通技能教师评价量表,并检测其信效度。方法:应用小组访谈、半结构式访谈和专家咨询收集和筛选条目。通过观察312名住院医师病房实际表现实施量表评估,同时应用Segue量表对其中94名住院医师进行评价以检验平行效度。间隔2周进行重测。模拟临床情景考核94名住院医师以检验效标效度。结果:量表包括入院问诊、检查、特殊情景、治疗和出院沟通4个维度共31个条目。总量表Cronbach’sα系数为0.948,各维度为0.783~0.908;总量表重测信度为0.905,各维度为0.779~0.889;量表的平行效度、实证效度检验结果均达到测量学标准。验证性因子分析显示各拟合指标合理。结论:本研究编制的住院医师“四情境”医患沟通技能教师评价量表具有良好的信效度,可作为住院医师医患沟通技能的教师用评价工具。

Objective:To develop a novel“four-situation”scale for assessing residents’doctor-patient communication(DPC)skills in specific clinical situations,and to test its reliability and validity.Methods:Focus group,semi-structured interview and expert consultation were used to construct the“four-situation”scale.The scale was administered by observing the actual performance of 312 residents on the ward.The Segue Scale was used to measure parallel validity(n=94),with retesting completed after 2-week.94 of the residents were assessed by simulated clinical scenarios to test the criterion validity.Results:The scale had 4 communication dimensions(admission,examinations,specific situations,treatment and discharge)and 31 items.Cronbach’s alpha coefficient of the total scale was 0.948,and of each dimension ranged from 0.783to 0.908;retest reliability of the total scale was 0.905,and of each dimension ranged from 0.779 to 0.889.Both the test of parallel validity and criterion validity showed a correlation of 0.001 significant level.Confirmatory factor analysis showed that the structure of the scale was reasonable.Conclusion:Residents’doctor-patient communication skills could be assessed with the novel“four-situation”scale with good reliability and validity.