Want to assess doctors’ communication skills? Introducing the Global Consultation Rating Scale (or GCRS, for short)

We think (and hope you do too) that improving communication between patients and their doctors is A Good Thing. Good communication is a key part of good patient experience, and an important aspect of high quality care. NICE have recognised this too: their Quality Standard on patient experience in adult NHS services requires that “Patients experience effective interactions with staff who have demonstrated competency in relevant communication skills.” Recent analysis by colleagues of English national GP patient survey data has shown that doctor communication is the strongest driver of patient satisfaction with GP care. Effective communication can have a notable impact on important patient health outcomes too, including emotional health, symptom resolution, functional and physiological measures and pain control. More recent analysis of English GP Patient Survey and Quality and Outcomes Framework (QOF) data (by colleagues again, we do a lot of it here…) found positive associations between patient-reported doctor communication skills and the technical quality of care provided by a practice, suggesting that clinical care does not have to suffer if a doctor also makes an effort to communicate well.

Communication is usually measured from the patients’ point of view. This is important. It’s also (relatively) cheap and easy. But what this doesn’t tell us is how a doctor consistently performs against agreed professional standards. In our current work, we have been looking to develop a way both of assessing communication skills, and of linking assessments to existing training opportunities so any issues can be addressed. Our new scale – the Global Consultation Rating Scale (GCRS) – does just this. We have derived GCRS from the Calgary-Cambridge guide to the medical interview, an internationally used, evidence-based method for teaching communication skills. Drawing on the Calgary Cambridge approach, GCRS provides 12 generic communication process domains from “initiating the session” to “closure”, with guidance as to the exact nature of the skills assessed within each domain. GCRS has been specifically developed to evaluate a doctor’s overall communication skills, identify their consultation skills learning needs, and link directly with the Calgary Cambridge guide as an educational method for meeting those needs. So far, we only know that the GCRS is robust and reliable when assessing the communication quality of single consultations. We are hoping, in a new phase of work, to assess how it performs when assessing the performance of a doctor across lots of different consultations. We’ll tell you the answer to that one if we get the funding we’ve asked for!

Read the full paper here:

Burt J, Abel G, Elmore N, Campbell J, Roland M, Benson J, Silverman J. Assessing communication quality of consultations in primary care: initial reliability of the Global Consultation Rating Scale, based on the Calgary-Cambridge Guide to the Medical Interview.

BMJ Open 2014;4:e004339 doi:10.1136/bmjopen-2013-004339
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  • The Cambridge Centre for Health Services Research (CCHSR) is a thriving collaboration between the University of Cambridge and RAND Europe. We aim to inform health policy and practice by conducting research and evaluation studies of organisation and delivery of healthcare, including safety, effectiveness, efficiency and patient experience.