TY - JOUR
T1 - Behavioral Coding for Evaluation of Medical Student Communication
T2 - Clarification or Obfuscation?
AU - Sloane, Philip D.
AU - Beck, Rainer
AU - Kowlowitz, Vicki
AU - Blotzer, Angela M.
AU - Wang, Lily
AU - Akins, Luzmila
AU - White-Chu, Foy
AU - Mitchell, C. Madeline
PY - 2004/2
Y1 - 2004/2
N2 - Purpose. To understand which specific student behaviors predict performance ratings from standardized patients and behavioral scientist preceptors. Method. In 1996-98, objective, real-time ratings of student verbal and nonverbal behaviors were conducted on 75 videotaped interviews between second-year medical students and standardized patients at University of North Carolina at Chapel Hill School of Medicine. The coding system used in these analyses was developed based on evidence-based literature reviews and used software that provides for real-time recording; 30 nonverbal and 33 behaviors were coded. The coded behaviors were then compared with four ratings: a global rating of the encounter by the standardized patient, a summary score derived from a checklist completed by the standardized patient, a global rating of the encounter by a behavioral science preceptor who observed the encounter, and a summary score derived from a checklist completed by the preceptor. Results. Analyses identified strong correlations between all four of the preceptor and patient ratings, a strong independent effect of case scenario, and significant between-rater variation. When multivariable analysis was used to predict these global ratings based on coding of specific behaviors, a relatively high proportion of observer variation was explained by a small group of coded behaviors. Conclusions. This study suggests that the coding of specific behaviors may hold promise as a student evaluation technique thereby improving medical training techniques and ultimately enhancing the communication skills in physician-patient encounters. It also illustrates the need to better clarify which specific behaviors are most critical in influencing patient satisfaction.
AB - Purpose. To understand which specific student behaviors predict performance ratings from standardized patients and behavioral scientist preceptors. Method. In 1996-98, objective, real-time ratings of student verbal and nonverbal behaviors were conducted on 75 videotaped interviews between second-year medical students and standardized patients at University of North Carolina at Chapel Hill School of Medicine. The coding system used in these analyses was developed based on evidence-based literature reviews and used software that provides for real-time recording; 30 nonverbal and 33 behaviors were coded. The coded behaviors were then compared with four ratings: a global rating of the encounter by the standardized patient, a summary score derived from a checklist completed by the standardized patient, a global rating of the encounter by a behavioral science preceptor who observed the encounter, and a summary score derived from a checklist completed by the preceptor. Results. Analyses identified strong correlations between all four of the preceptor and patient ratings, a strong independent effect of case scenario, and significant between-rater variation. When multivariable analysis was used to predict these global ratings based on coding of specific behaviors, a relatively high proportion of observer variation was explained by a small group of coded behaviors. Conclusions. This study suggests that the coding of specific behaviors may hold promise as a student evaluation technique thereby improving medical training techniques and ultimately enhancing the communication skills in physician-patient encounters. It also illustrates the need to better clarify which specific behaviors are most critical in influencing patient satisfaction.
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U2 - 10.1097/00001888-200402000-00013
DO - 10.1097/00001888-200402000-00013
M3 - Article
C2 - 14744718
AN - SCOPUS:1542318884
VL - 79
SP - 162
EP - 170
JO - Academic Medicine
JF - Academic Medicine
SN - 1040-2446
IS - 2
ER -