Rating Communication in GP Consultations

The Association Between Ratings Made by Patients and Trained Clinical Raters

Published in: Medical Care Research and Review, 2016

Posted on RAND.org on October 20, 2016

by Jenni A. Burt, Gary A. Abel, Natasha Elmore, Jennifer Newbould, Antoinette Davey, Nadia R. Llanwarne, Inocencio Maramba, Charlotte Paddison, John Benson, Jonathan Silverman, Marc N. Elliott, John Campbell, Martin Roland

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This article was published outside of RAND. The full text of the article can be found at the link above.

Research Question

  1. How do patients' assessments of patient-doctor communication compare to assessments by trained external observers?

Patient evaluations of physician communication are widely used, but we know little about how these relate to professionally agreed norms of communication quality. We report an investigation into the association between patient assessments of communication quality and an observer-rated measure of communication competence. Consent was obtained to video record consultations with Family Practitioners in England, following which patients rated the physician's communication skills. A sample of consultation videos was subsequently evaluated by trained clinical raters using an instrument derived from the Calgary-Cambridge guide to the medical interview. Consultations scored highly for communication by clinical raters were also scored highly by patients. However, when clinical raters judged communication to be of lower quality, patient scores ranged from "poor" to "very good." Some patients may be inhibited from rating poor communication negatively. Patient evaluations can be useful for measuring relative performance of physicians' communication skills, but absolute scores should be interpreted with caution.

Key Findings

  • Assessments from patients and observers show that both seem to agree on what constitutes good patient-physician communication, but may not agree on what constitutes poor communication.
  • Communication that was rated highly by trained observers also tended to be rated highly by patients.
  • Communication rated as poor by patients generally received poor ratings from observers.
  • However, when observers rated communication as poor, patients' ratings ranged from poor to very good, suggesting patients may be less likely than observers to criticize their doctors.

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