The Evaluation of Physicians' Communication Skills From Multiple Perspectives.
PURPOSE
To examine how family physicians', patients', and trained clinical raters' assessments of physician-patient communication compare by analysis of individual appointments.


METHODS
Analysis of survey data from patients attending face-to-face appointments with 45 family physicians at 13 practices in England. Immediately post-appointment, patients and physicians independently completed a questionnaire including 7 items assessing communication quality. A sample of videotaped appointments was assessed by trained clinical raters, using the same 7 communication items. Patient, physician, and rater communication scores were compared using correlation coefficients.


RESULTS
Included were 503 physician-patient pairs; of those, 55 appointments were also evaluated by trained clinical raters. Physicians scored themselves, on average, lower than patients (mean physician score 74.5; mean patient score 94.4); 63.4% (319) of patient-reported scores were the maximum of 100. The mean of rater scores from 55 appointments was 57.3. There was a near-zero correlation coefficient between physician-reported and patient-reported communication scores (0.009, P = .854), and between physician-reported and trained rater-reported communication scores (-0.006, P = .69). There was a moderate and statistically significant association, however, between patient and trained-rater scores (0.35, P = .042).


CONCLUSIONS
The lack of correlation between physician scores and those of others indicates that physicians' perceptions of good communication during their appointments may differ from those of external peer raters and patients. Physicians may not be aware of how patients experience their communication practices; peer assessment of communication skills is an important approach in identifying areas for improvement.
['Burt|Jenni|J|', 'Abel|Gary|G|', 'Elliott|Marc N|MN|', 'Elmore|Natasha|N|', 'Newbould|Jennifer|J|', 'Davey|Antoinette|A|', 'Llanwarne|Nadia|N|', 'Maramba|Inocencio|I|', 'Paddison|Charlotte|C|', 'Campbell|John|J|', 'Roland|Martin|M|']
D000293:Adolescent D000328:Adult D000368:Aged D000369:Aged, 80 and over D001291:Attitude of Health Personnel D003142:Communication D004739:England D005260:Female D006801:Humans D016014:Linear Models D008297:Male D008875:Middle Aged D015588:Observer Variation D017060:Patient Satisfaction D010817:Physician-Patient Relations D010821:Physicians, Family D012017:Referral and Consultation D014743:Videotape Recording D055815:Young Adult
physician-patient communication patient experience health care quality measurement health care surveys patient satisfaction physician-patient relations quality of health care