title: Measuring clinical skills in agenda-mapping (EAGL-I).
abstract: OBJECTIVE
  To develop and validate the Evaluation of AGenda-mapping skilL Instrument (EAGL-I).
  
  
  METHODS
  EAGL-I was constructed after a literature review and piloting. Simulated consultation recordings were collected in a workshop with third-year medical students at three time points: once pre-teaching, twice post-teaching. Three raters used EAGL-I to assess student agenda-mapping. We examined reliability, ability to detect change and predict full expression of patients' agendas.
  
  
  RESULTS
  EAGL-I scores represented reliable assessment of agenda-mapping (Ep(2)=0.832; φ=0.675). Generalizability coefficients across items (Ep(2)=0.836) and raters (φ=0.797 two raters) were acceptable. A one-way repeated measure ANOVA with post hoc analysis found a statistically significant difference between the pre-teaching occasion of measurement and each post-teaching occasion (p<0.001) and no significant difference between the two post-teaching occasions (p=0.085). Multilevel logistic regression show scores predict expression of scripted hidden agendas irrespective of occasions, or patient scenario (n=60, p=0.005).
  
  
  CONCLUSIONS
  Evidence of measure validation is shown. Reliability is optimised when two or more raters use EAGL-I and agenda-mapping has been taught. EAGL-I appears sensitive to change. Higher scores predict the likelihood that a patient will disclose their full agenda in a simulated environment.
  
  
  CONCLUSIONS
  A validated tool for measuring agenda-mapping in teaching and research is now available.
authors.affiliation: Cochrane Institute of Primary Care and Public Health, Cardiff University, Cardiff, UK. Electronic address: GobatNH@cardiff.ac.uk.
authors.forename: Nina
authors.initials: N
authors.lastname: Gobat
authors.affiliation: Institute of Medical Education, Cardiff University, Cardiff, UK.
authors.forename: Paul
authors.initials: P
authors.lastname: Kinnersley
authors.affiliation: Institute of Molecular and Experimental Medicine, Cardiff University, Cardiff, UK.
authors.forename: John W
authors.initials: JW
authors.lastname: Gregory
authors.affiliation: South East Wales Trials Unit, Cardiff University, Cardiff, UK.
authors.forename: Timothy
authors.initials: T
authors.lastname: Pickles
authors.affiliation: South East Wales Trials Unit, Cardiff University, Cardiff, UK.
authors.forename: Kerenza
authors.initials: K
authors.lastname: Hood
authors.affiliation: South East Wales Trials Unit, Cardiff University, Cardiff, UK.
authors.forename: Michael
authors.initials: M
authors.lastname: Robling
mesh_terms: D002983:Clinical Competence; D004521:Educational Measurement; D005260:Female; D058015:Health Communication; D006801:Humans; D016015:Logistic Models; D008297:Male; D055361:Multilevel Analysis; D011369:Professional-Patient Relations; D011594:Psychometrics / Q000295:instrumentation*; D015203:Reproducibility of Results; D000066908:Simulation Training; D013337:Students, Medical; D013663:Teaching
keywords: Agenda-mapping; Establish focus; Measure development; Measure validation; Skills assessment; Teaching