Children and their parents assessing the doctor-patient interaction: a rating system for doctors' communication skills

Med Educ. 2005 Aug;39(8):820-8. doi: 10.1111/j.1365-2929.2005.02230.x.


Context: Only a patient and his or her family can judge many of the most important aspects of the doctor-patient interaction. This study evaluates the feasibility and reliability of children and their families assessing the quality of paediatricians' interactions using a rating instrument developed specifically for this purpose.

Methods: A reliability analysis using generalisability theory on the ratings from 352 doctor-patient interactions across different speciality clinics.

Results: Ratings were normally distributed. They were highest for 'overall' performance, and lowest for giving time to discuss the families' agenda. An appropriate sample of adults' ratings provided a reliable score (G = 0.7 with 15 raters), but children's ratings were too idiosyncratic to be reproducible (G = 0.36 with 15 raters). CONCLUSIONS AND FURTHER WORK: Accompanying adults can provide reliable ratings of doctors' interactions with children. Because an adult is usually present at the consultation their ratings provide a highly feasible and authentic approach. Sampling doctors' interactions from different clinics and with patients of both genders provides a universal picture of performance. The method is ideal to measure performance for in-training assessment or revalidation. Further work is in progress to evaluate the educational impact of feeding ratings back to the doctors being assessed, and their use in a range of clinical contexts.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Child*
  • Clinical Competence / standards*
  • Communication*
  • Feasibility Studies
  • Humans
  • Parents*
  • Pediatrics / standards*
  • Physician-Patient Relations*