Feasibility and validation of real-time patient evaluations of internal medicine interns' communication and professionalism skills.
BACKGROUND
Residents receive little information about how they interact with patients.


OBJECTIVE
This pilot study assessed the feasibility and validity of a new 16-item tool developed to assess patients' perspectives of interns' communication skills and professionalism and the team's communication.


METHODS
Feasibility was determined by the percentage of surveys completed, the average time for survey completion, the percentage of target interns evaluated, and the mean number of evaluations per intern. Generalizability was analyzed using an (evaluator:evaluatee) × item model. Simulated D studies estimated optimal numbers of items and evaluators. Factor analysis with varimax rotation was used to examine the structure of the items. Scores were correlated with other measures of communication and professionalism for validation.


RESULTS
Most patients (225 of 305 [74%]) completed the evaluation. Each survey took approximately 6.3 minutes to complete. In 43 days over 18 weeks, 45 of 50 interns (90%) were evaluated an average of 4.6 times. Fifty evaluations would be required to reach a minimally acceptable coefficient (0.57). Two factor structures were identified. The evaluation did not correlate with faculty evaluations of resident communication but did correlate weakly (r  =  0.140, P  =  .04) with standardized patient evaluations.


CONCLUSIONS
A large number of patient evaluations are needed to reliably assess intern and team communication skills. Evaluations by patients add a perspective in assessing these skills that is different from those of faculty evaluations. Future work will focus on whether this new information adds to existing evaluation systems and warrants the added effort.
C Jessica
CJ
Dine
Stefanie
S
Ruffolo
Jennifer
J
Lapin
Judy A
JA
Shea
Jennifer R
JR
Kogan