Researchers: Joseph Pliskin¹, Iris Reychav², Tsipi Heart³, Shmuel Reis⁴

Background: Patient-doctor communication entails significant ramifications on the quality and outcomes of medical care. Guidelines and communication assessment tools have been developed to ensure and enhance physician communication skills. Computer use in primary care has strongly affected the physician's ability to maintain effective communication with patients. Nevertheless, to date, suitable guidelines and assessment tools have not been methodologically developed.

Objectives: Methodologically develop and validate a communication assessment tool that is relevant for the computerized exam room. The proposed tool will offer guidelines for correct computer use while maintaining effective communication with patients.

Method: Data were accumulated based on existing literature, expert panels, questionnaires and simulations of encounters and included the following stages:
• Item generation was based on existing literature;
• Content validity analysis via two expert panels;
• Statistical validation included coders' training and inter-rater reliability based on videotaped simulated medical encounters.

Findings: The item generation process was primarily based on the literature and resulted in the generation of 27 items. In the first panel, 20 items were rated as important for establishing effective patient-doctor communication during computer use. The second panel re-examined the items and resulted in a total of 22 items that will represent the e-SEGUE assessment tool. The statistical analysis stage included the training of two coders. After sufficient methodological training, they rated 56 videotaped simulated medical encounters that took place in a computerized exam room. 70% of the items received between moderate and perfect agreement.

Conclusions: The e-SEGUE is a reliable tool that can be applied for assessing physicians' communication with their patients during computer use. The e-SEGUE can be used as guidelines for integrating EMRs in primary care while maintaining effective communication and patient-centered care, as well as an assessment tool for learning purposes such as evaluation and feedback for physicians starting from medial school to later stages of residency. It can likewise serve as a benchmark for appropriate EMR use by physicians in the primary care clinic.

Recommendations: It is recommended to incorporate the e-SEGUE for evaluation, feedback, learning and training physicians in all levels of residency.

Research end date: 07/2017