title: Development and evaluation of the "BRISK Scale," a brief observational measure of risk communication competence.
abstract: To develop and evaluate a brief observational measure of clinical risk communication competence.
  
  
  
  A 4-item checklist-type measure, the BRISK (Brief Risk Information Skill) Scale, was developed by selecting and refining items from a more comprehensive measure of clinical risk communication competence. Six volunteer raters received brief training on the measure and then used the BRISK Scale to evaluate 52 video-recorded encounters between 2nd-year medical students and standardized patients conducted as part of an Observed Structured Clinical Examination (OSCE) involving a risk communication task. Internal consistency reliability, inter-rater reliability, and criterion validity were assessed.
  
  
  
  Raters reported no difficulties using the BRISK Scale; scores across all raters and subjects ranged from 0 to 16 with a mean score of 6.49 (SD=3.17). The BRISK Scale showed good internal consistency reliability (α=0.64), and inter-rater reliability at the scale level (Intraclass Correlation Coefficient (ICC)=0.79 for consistency, and 0.75 for absolute agreement) and individual-item level (ICC range: 0.62-.91). Novice raters' BRISK Scale scores were highly correlated (r=0.84, p<0.01) with expert raters' scores on the Risk Communication Content measure, a more comprehensive measure of risk communication competence.
  
  
  
  The BRISK Scale is a promising new brief observational measure of clinical risk communication competence.
authors.affiliation: Center for Outcomes Research and Evaluation, Maine Medical Center, Portland, ME, United States; Tufts University Clinical and Translational Sciences Institute, Boston, MA, United States. Electronic address: hanp@mmc.org.
authors.forename: Paul K J
authors.initials: PK
authors.lastname: Han
authors.affiliation: Centre for Medical and Healthcare Education, St George's, University of London, London, UK.
authors.forename: Katherine
authors.initials: K
authors.lastname: Joekes
authors.affiliation: Center for Outcomes Research and Evaluation, Maine Medical Center, Portland, ME, United States.
authors.forename: Greg
authors.initials: G
authors.lastname: Mills
authors.affiliation: Center for Outcomes Research and Evaluation, Maine Medical Center, Portland, ME, United States.
authors.forename: Caitlin
authors.initials: C
authors.lastname: Gutheil
authors.affiliation: Center for Outcomes Research and Evaluation, Maine Medical Center, Portland, ME, United States.
authors.forename: Kahsi
authors.initials: K
authors.lastname: Smith
authors.affiliation: Dartmouth Center for Healthcare Delivery Science, Hanover, NH, United States.
authors.forename: Nancy E
authors.initials: NE
authors.lastname: Cochran
authors.affiliation: Dartmouth Center for Healthcare Delivery Science, Hanover, NH, United States.
authors.forename: Glyn
authors.initials: G
authors.lastname: Elwyn
mesh_terms: D000293:Adolescent; D000328:Adult; D002983:Clinical Competence / Q000592:standards*; D003142:Communication; D003657:Decision Making; D004504:Education, Medical, Undergraduate / Q000379:methods*; D004521:Educational Measurement / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D015588:Observer Variation; D010808:Physical Examination; D011594:Psychometrics / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D012306:Risk; D013337:Students, Medical; D014741:Video Recording; D055815:Young Adult
keywords: Measurement; Medical education; Risk communication; Shared decision making