Setting a standard for performance assessment of doctor-patient communication in general practice.
BACKGROUND
Continuing professional development (CPD) of general practitioners.


OBJECTIVE
Criterion-referenced standards for assessing performance in the real practice of general practitioners (GPs) should be available to identify learning needs or poor performers for CPD. The applicability of common standard setting procedures in authentic assessment has not been investigated.


METHODS
To set a standard for assessment of GP-patient communication with video observation of daily practice, we investigated 2 well known examples of 2 different standard setting approaches. An Angoff procedure was applied to 8 written cases. A borderline regression method was applied to videotaped consultations of 88 GPs. The procedures and outcomes were evaluated by the applicability of the procedure, the reliability of the standards and the credibility as perceived by the stakeholders, namely, the GPs.


RESULTS
Both methods are applicable and reliable; the obtained standards are credible according to the GPs.


CONCLUSIONS
Both modified methods can be used to set a standard for assessment in daily practice. The context in which the standard will be used - i.e. the specific purpose of the standard, the moment the standard must be available or if specific feedback must be given - is important because methods differ in practical aspects.
Hobma
S O
SO
Department of General Practice, Centre for Quality of Care Research, University of Maastricht, Maastricht, The Netherlands. sjoerd.hobma@hag.unimaas.nl
Ram
P M
PM
Muijtjens
A M M
AM
Grol
R P T M
RP
van der Vleuten
C P M
CP
D002983:Clinical Competence / Q000592:standards; D003142:Communication; D004502:Education, Medical, Continuing / Q000592:standards*; D005194:Family Practice / Q000592:standards*; D006801:Humans; D010817:Physician-Patient Relations; D012017:Referral and Consultation; D014743:Videotape Recording / Q000379:methods