Assessment of a matched-pair instrument to examine doctor?patient communication skills in practising doctors

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Abstract
To develop and psychometrically assess the feasibility, reliability and validity of an assessment tool in which both doctor and patient perceptions of the communication that occurred in a single office visit are captured. Two 19-item (5-point scale) questionnaires, with parallel content, were developed for doctor and patient completion following a visit. Both process and content were queried. Family doctors and specialists across Canada were recruited to provide data from 25 visits. We assessed feasibility by examining recruitment and percentages of people 'unable to assess' each item. Evidence for validity was examined through exploratory factor analysis, the correlations between doctor and patient data and linear regression. Reliability was assessed through internal consistency reliability and generalisability coefficient analyses. Data from 1845 doctor-patient dyads (91 doctors) showed similarly high ratings (> 4/5) for both doctors and patients, with few unable-to-assess items. There were low correlations between items and questionnaires. The principle components analysis indicated 2 factors, process and content, accounting for 52% and 7% of the doctor variance and 60% and 6% of the patient variance, respectively. The linear regression showed that only gender accounted for any of the variance in ratings. Cronbach's alphas for both doctor and patient questionnaires were > or = 0.96. The G analysis provided a G = 0.98 and 0.40 (standard errors of 0.003 and 0.02) for doctors and patients, respectively. The data suggest this is a feasible tool with which to assess communication skills and that there is evidence for its validity and reliability.