title: Evaluation of the FOCUS (Feedback on Counseling Using Simulation) instrument for assessment of client-centered nutrition counseling behaviors.
abstract: OBJECTIVE
  To develop an instrument to assess client-centered counseling behaviors (skills) of student-counselors in a standardized patient (SP) exercise.
  
  
  METHODS
  Descriptive study of the accuracy and utility of a newly developed counseling evaluation instrument. Study participants included 11 female student-counselors at a Midwestern university-10 Caucasian, 1 African-American-for the simulated counseling sessions, in which the Feedback on Counseling Using Simulation (FOCUS) instrument was applied in 2 SP scenarios (cardiovascular disease and diabetes). FOCUS ratings of student-counselors by 4 SPs during 22 sessions were compared with ratings from a 3-member panel of experts who independently viewed the 22 videotaped sessions. Quantitative analysis of instrument validity included inter-rater reliability by computing generalizability coefficients, Pearson correlations, and Spearman rank-order correlations.
  
  
  RESULTS
  FOCUS criteria encompassed relevant dimensions of nutrition counseling based in a client-centered perspective. The critical points of information gathering and counseling behaviors showed internal consistency overall and good inter-rater reliability with the cardiovascular disease scenario. For both scenarios, pooled ratings of 3 experts agreed with ratings carried out by SPs.
  
  
  CONCLUSIONS
  Initial findings suggest that the FOCUS instrument with client-centered criteria may enhance evaluation of counseling skills in SP exercises, meriting further study with larger groups.
authors.affiliation: School of Family, Consumer & Nutrition Sciences, College of Health & Human Sciences, Northern Illinois University, DeKalb, IL 60115, USA. bwhenry@niu.edu
authors.forename: Beverly W
authors.initials: BW
authors.lastname: Henry
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Smith
mesh_terms: D003376:Counseling / Q000193:education*; D005260:Female; D015438:Health Behavior; D006801:Humans; D015146:Midwestern United States; D052756:Nutritional Sciences / Q000193:education*; D016544:Patient Simulation; D010865:Pilot Projects; D011369:Professional-Patient Relations; D012381:Role Playing; D013334:Students; D011795:Surveys and Questionnaires; D014495:Universities; D014743:Videotape Recording