Skip to main content

Advertisement

SpringerLink
Log in

Assessing Communication Skills in Real Medical Encounters in Oncology: Development and Validation of the ComOn-Coaching Rating Scales

  • Published:
Journal of Cancer Education Aims and scope Submit manuscript

Abstract

One of the challenges in research on teaching physician-patient communication is how to assess communication, necessary for evaluating training, the learning process, and for feedback. Few instruments have been validated for real physician-patient consultations. Real consultations involve unique contexts, different persons, and topics, and are difficult to compare. The aim of this study is to develop and validate a rating scale for assessment of such consultations. For the evaluation study of a communication skills training for physicians in oncology, real consultations were recorded in three assessment points. Based on earlier work and on current studies, a new instrument was developed for assessment of these consultations. Two psychologists were trained in using the instrument and assessed 42 consultations. For inter-rater reliability, interclass correlation (ICC) was calculated. The final version of the rating scales consists of 13 items evaluated on a 5-point scale. The items are grouped in seven areas: “Start of conversation,” “assessment of the patient’s perspective,” “structure of conversation,” “emotional issues,” “end of conversation,” “general communication skills,” and “overall evaluation.” ICC coefficients for the domains ranged from .44 to .77. An overall coefficient of all items resulted in an ICC of .66. The ComOn-Coaching Rating Scales are a short, reliable, and applicable instrument for the assessment of real physician-patient consultations in oncology. If adapted, they could be used in other areas. They were developed for research and teaching purposes and meet the required methodological criteria. Rater training should be considered more deeply by further research.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Hack TF, Degner LF, Parker PA (2005) The communication goals and needs of cancer patients: a review. Psychooncology 14:831–845. doi:10.1002/pon.949

    Article  PubMed  Google Scholar 

  2. Bensing JM, Deveugele M, Moretti F, Fletcher I, van Vliet L, Van Bogaert M, Rimondini M (2011) How to make the medical consultation more successful from a patient’s perspective? Tips for doctors and patients from lay people in the United Kingdom, Italy, Belgium and the Netherlands. Patient Educ Couns 84:287–293. doi:10.1016/j.pec.2011.06.008

    Article  PubMed  Google Scholar 

  3. Baile WF, Aaron J (2005) Patient-physician communication in oncology: past, present, and future. Curr Opin Oncol 17:331–335

    Article  Google Scholar 

  4. Pham AK, Bauer MT, Balan S (2014) Closing the patient–oncologist communication gap: a review of historic and current efforts. J Cancer Educ 29:106–113. doi:10.1007/s13187-013-0555-0

    Article  PubMed  Google Scholar 

  5. Epstein RM, Street RL (2007) Patient-centered communication in cancer care: promoting healing and reducing suffering. NIH Publication No. 07-6225. National Cancer Institute, Bethesda Online: https://healthcaredelivery.cancer.gov/pcc/pcc_monograph.pdf

    Google Scholar 

  6. Lundberg KL (2014) What are internal medicine residents missing? A communication needs assessment of outpatient clinical encounters. Patient Educ Couns 96:376–380. doi:10.1016/j.pec.2014.07.015

    Article  PubMed  Google Scholar 

  7. Thorne SE, Bultz BD, Baile WF (2005) Is there a cost to poor communication in cancer care? A critical review of the literature. Psychooncology 14:875–884 (discussion 885-886. doi:10.1002/pon.947

    Article  PubMed  Google Scholar 

  8. Barth J, Lannen P (2011) Efficacy of communication skills training courses in oncology: a systematic review and meta-analysis. Ann Oncol 22:1030–1040. doi:10.1093/annonc/mdq441

    Article  CAS  PubMed  Google Scholar 

  9. Moore PM, Mercado SR, Artigues MG, Lawrie TA (2013) Communication skills training for healthcare professionals working with people who have cancer. Cochrane Database Syst Rev 3:CD003751. doi:10.1002/14651858.CD003751.pub3

    Article  Google Scholar 

  10. Goelz T, Wuensch A, Stubenrauch S, Ihorst G, de Figueiredo M, Bertz H, Wirsching M, Fritzsche K (2011) Specific training program improves oncologists’ palliative care communication skills in a randomized controlled trial. J Clin Oncol 29:3402–3407. doi:10.1200/JCO.2010.31.6372

    Article  PubMed  Google Scholar 

  11. Wuensch A, Goelz T, Ihorst G, Terris DD, Bertz H, Juergen Bengel J, Wirsching M, Fritzsche K (2017) Effect of individualized communication skills training on physicians’ discussion of clinical trials in oncology: results from a randomized controlled trial. BMC Cancer 17:264. doi:10.1186/s12885-017-3238-0

    Article  PubMed  PubMed Central  Google Scholar 

  12. Cegala DJ, Broz SL (2002) Physician communication skills training: a review of theoretical backgrounds, objectives and skills. Med Educ 36:1004–1016

    Article  Google Scholar 

  13. Stubenrauch S, Schneid E-M, Wünsch A, Helmes A, Bertz H, Fritzsche K, Wirsching M, Gölz T (2012) Development and evaluation of a checklist assessing communication skills of oncologists: the COM-ON-Checklist. J Eval Clin Pract 18:225–230. doi:10.1111/j.1365-2753.2010.01556.x

    Article  PubMed  Google Scholar 

  14. Baile WF, Buckmann R, Lenzi R, Glober G, Beale EA, Kudelka AP (2000) SPIKES—a six-step protocol for delivering bad news: application to the patient with cancer. Oncologist 5:302–311

    Article  CAS  Google Scholar 

  15. de Figueiredo N, Marcelo BR, Bylund CL, Goelz T, Heußner P, Sattel H, Fritzsche K, Wuensch A (2015) ComOn Coaching: study protocol of a randomized controlled trial to assess the effect of a varied number of coaching sessions on transfer into clinical practice following communication skills training. BMC Cancer 15:503. doi:10.1186/s12885-015-1454-z

    Article  Google Scholar 

  16. Langewitz W, Ackermann S, Heierle A, Hertwig R, Ghanim L, Bingisser R (2015) Improving patient recall of information: harnessing the power of structure. Patient Educ Couns 98:716–721. doi:10.1016/j.pec.2015.02.003

    Article  PubMed  Google Scholar 

  17. Radziej, Katharina, Alexander Wuensch, Johanna Loechner, Cosima Engerer, Marcelo Niglio de Figueiredo, Johanna Freund, Heribert Sattel, Cadja Bachmann, Pascal O Berberat & Andreas Dinkel. In Review. How to assess communication skills? Development of the rating scale ComOn Check

  18. Landis JR, G. G. Koch GG. (1977) The measurement of observer agreement for categorical data. Biometrics 33:159–174

    Article  CAS  Google Scholar 

  19. Wirtz M, Caspar F (2002) Beurteilungsübereinstimmungen und Beurteilerreliabilität. [Assessment Agreement and Rater Reliability] Hogrefe, Göttingen

  20. Landers RN (2015) Computing intraclass correlations (ICC) as estimates of interrater reliability in SPSS. Winnower 2:e14351881744. doi:10.15200/winn.143518.81744

    Article  Google Scholar 

  21. Salmon P, Young B (2011) Creativity in clinical communication: from communication skills to skilled communication. Med Educ 45:217–226. doi:10.1111/j.1365-2923.2010.03801.x

    Article  PubMed  Google Scholar 

  22. Peterson EB, Calhoun AW, Rider EA (2014) The reliability of a modified Kalamazoo Consensus Statement Checklist for assessing the communication skills of multidisciplinary clinicians in the simulated environment. Patient Educ Couns 96:411–418. doi:10.1016/j.pec.2014.07.013

    Article  PubMed  Google Scholar 

  23. Kroboth FJ, Hanusa BH, Parker S, Coulehan JL, Kapoor W, Brown FH, Karpf M, Levey GS (1992) The inter-rater reliability and internal consistency of a clinical evaluation exercise. J Gen Intern Med 7:174–179. doi:10.1007/BF02598008

    Article  CAS  PubMed  Google Scholar 

  24. Feldman M, Lazzara EH, Vanderbilt AA, DiazGranados D (2012) Rater training to support high-stakes simulation-based assessments. J Contin Educ Heal Prof 32:279–286. doi:10.1002/chp.21156

    Article  Google Scholar 

  25. Eppich W, Nannicelli AP, Seivert NP, Sohn M-W, Rozenfeld R, Woods DM, Holl JL (2015) A rater training protocol to assess team performance. J Contin Educ Heal Prof 35:83–90. doi:10.1002/chp.21270

    Article  Google Scholar 

Download references

Acknowledgements

The ComOn-Coaching Project was made possible by the financial support of the German Cancer Aid. The article processing charge was funded by the German Research Foundation (DFG) and the University of Freiburg in the funding program Open Access Publishing. We thank Angela Vöhringer and Christopher Koppermann for the rating work and all physicians and patients for making this project possible.

Author information

Authors and Affiliations

  1. Department of Psychosomatic Medicine and Psychotherapy, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstr. 8, Freiburg, 79104, Germany

    Marcelo Niglio de Figueiredo, Lorena Krippeit, Johanna Freund, Andreas Joos & Alexander Wuensch

  2. Department of Dermatology and Venereology, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstr. 7, Freiburg, 79104, Germany

    Marcelo Niglio de Figueiredo

  3. Clinical Trials Unit, Medical Center—University of Freiburg Faculty of Medicine, University of Freiburg, Freiburg, Germany

    Gabriele Ihorst

  4. Rehabilitation Psychology and Psychotherapy, Department of Psychology, University of Freiburg, Freiburg, Germany

    Juergen Bengel

  5. Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany

    Alexander Wuensch

Authors
  1. Marcelo Niglio de Figueiredo
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Lorena Krippeit
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Johanna Freund
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Gabriele Ihorst
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Andreas Joos
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Juergen Bengel
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Alexander Wuensch
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Marcelo Niglio de Figueiredo.

Ethics declarations

The study was fully approved by the ethics committees of the Medical Center – University of Freiburg, Freiburg, Germany, and of the University Hospital Klinikum rechts der Isar, Munich, Germany, and is registered under DRKS00004385 in the DRKS (German Clinical Trials Register). The corresponding author (Marcelo Niglio de Figueiredo) has full control of all primary data and agrees to allow the journal to review the data if requested.

Conflict of Interest

The authors have no conflict of interests to declare.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Electronic supplementary material

ESM 1

(PDF 35 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Niglio de Figueiredo, M., Krippeit, L., Freund, J. et al. Assessing Communication Skills in Real Medical Encounters in Oncology: Development and Validation of the ComOn-Coaching Rating Scales. J Canc Educ 34, 73–81 (2019). https://doi.org/10.1007/s13187-017-1269-5

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13187-017-1269-5

Keywords

Search

Navigation