title: Detecting the effects of physician training in self-care interviewing skills: Coding of standardized patient (SP) visit recordings versus SP post-visit ratings.
abstract: To compare how coder ratings of standardized patient (SP) visit recordings and SP ratings of the visits detect primary care physician (PCP) training in self-efficacy enhancing interviewing techniques (SEE IT).
  
  
  
  Analyses of data from 50 PCPs who participated in a randomized controlled trial of SEE IT training, which led to increased SEE IT use during three SP visits 1-3 months post-intervention. Untrained SPs rated SEE IT use post-visit. Subsequently, three trained coders generated a consensus SEE IT rating from visit audio recordings. SPs and coders were blinded to provider study arm, and coders to SP ratings.
  
  
  
  SP and coder ratings were correlated (r=0.62). In detecting the intervention effect, the areas under the receiver operating characteristic curve were 0.80 (95% CI 0.74-0.87) and 0.76 (95% CI 0.69-0.84) for consensus coder and SP ratings, respectively (difference 0.04, 95% CI -0.04-0.11; z=1.04, p=0.30).
  
  
  
  SP ratings were not significantly different from coder ratings of SP visit recordings in detecting PCP SEE IT training.
  
  
  
  If similar findings are observed in larger studies, it would suggest a greater role for SP ratings in detecting provider interviewing skills training, given the relative simplicity, low cost, and non-intrusiveness of the approach.
authors: Department of Family and Community Medicine, University of California Davis, Sacramento, USA. Electronic address: afjerant@ucdavis.edu.
authors: Anthony
authors: A
authors: Jerant
authors: Department of Family and Community Medicine, University of California Davis, Sacramento, USA. Electronic address: bwhanson@ucdavis.edu.
authors: Brent
authors: B
authors: Hanson
authors: Department of Internal Medicine, University of California Davis, Sacramento, USA. Electronic address: rlkravitz@ucdavis.edu.
authors: Richard L
authors: RL
authors: Kravitz
authors: Center for Healthcare Policy and Research, University of California Davis, Sacramento, USA. Electronic address: djtancredi@ucdavis.edu.
authors: Daniel J
authors: DJ
authors: Tancredi
authors: Center for Healthcare Policy and Research, University of California Davis, Sacramento, USA. Electronic address: enhess@ucdavis.edu.
authors: Emily
authors: E
authors: Hanes
authors: Center for Healthcare Policy and Research, University of California Davis, Sacramento, USA.
authors: Sanjeet
authors: S
authors: Grewal
authors: Center for Healthcare Policy and Research, University of California Davis, Sacramento, USA. Electronic address: rpcabrera@ucdavis.edu.
authors: Rimaben
authors: R
authors: Cabrera
authors: Department of Family and Community Medicine, University of California Davis, Sacramento, USA. Electronic address: pfranks@ucdavis.edu.
authors: Peter
authors: P
authors: Franks
mesh_terms: D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D009042:Motivation; D010353:Patient Education as Topic; D016544:Patient Simulation; D058007:Physicians, Primary Care; D011237:Predictive Value of Tests; D011320:Primary Health Care / Q000379:methods*; D012648:Self Care / Q000379:methods*; D020377:Self Efficacy; D013637:Tape Recording
keywords: Area under curve; Audio recording; Interviews as topic; Motivation; Predictive validity; Primary care; Self-efficacy; Standardized patients