JMIR Publications

ABSTRACT

Background:

Although well-designed tools to assess communication during medical interviews and complex encounters exist, valid assessment tools to assess communication during ethically sensitive situations that includes domains such as moral judgment and management of ethical conflicts are needed. In this context, we created an assessment tool that includes key competencies associated with practice in ethically challenging situations that are grouped into three distinct categories: communication, civility and respect, clinical and ethical judgment and decision-making.

Objective:

The objective of this project is to pilot-test an assessment tool that balances the demands of clinical decision-making while addressing sensitive ethical features of these scenarios that respects patients and family members. We describe the logic of the Assessment Communication Tool for Ethics (ACT4Ethics) and the study method that we will use to obtain validity evidence to support the scale construction.

Methods:

We will follow a multi-phase project designed according to modern validity principles including content, response process, internal structure, relation to other variables, and consequences. The design considers threats to validity such as construct underrepresentation and factors exerting nonrandom influence on scores. The project includes two parts: 1) train the raters in the use of the tool, and 2), a simulation pilot Scenario Oriented Learning in Ethics (SOLE) workshop.

Results:

A total of 60 independent assessments from 10 trained raters will be obtained for analysis. A comparison of raters’ performance will allow us to compute a measure of interrater reliability. Participants will provide feedback on a standard form. This project will take 18 months to complete and the results should be made available by December 2019.

Conclusions:

The ACT4Ethics will allow clinician teachers to assess and monitor competency levels of trainees’ communication skills when navigating ethically sensitive clinical situations. It will also guide them in providing meaningful feedback to the trainees more likely to impact trainees’ learning of appropriate communication skills.