Development and validation of the "FrOCK": Frankfurt observer communication checklist

Appropriate communication behaviour during medical consultations has been shown to improve doctor-patient relationships, and should therefore be an integral part of medical training. In Germany, though, there are almost no reliable and validated checklists for assessing communication skills during medical examinations. Our aim was to develop and validate the first German checklist to examine communication skills that can be used during examinations: the Frankfurt Observer Communication Checklist (FrOCK).

The checklist was developed according to a set of requirements that would need to be met by medical training checklists. It was pilot tested, revised and validated over several steps. Data analyses are provided for 371 assessments (371 students) by 17 examiners. After reviewing face validity and comprehensibility, we also checked for validity by comparing a trained and an untrained group of students and testing for both inter- and intrarater reliability. Interrater reliability was analysed by means of 37 interviews that were simultaneously assessed by five examiners. Intrarater reliability was calculated by having three examiners assess the same 37 students at two different points in time.

The final version of FrOCK consists of 31 items for conducting medical interviews which can be broadly divided into four areas: "beginning and conclusion of the interview", "interview technique", "contact skills /empathy" and "history taking". Several aspects of validity could be demonstrated, and both intra- and interrater reliability were high.

The results of this study have shown that FrOCK is a clear and concise checklist for assessing communication skills in medical examinations and one that satisfies psychometric requirements as well. It takes only 3 to 5minutes to complete and thus is particularly useful for assessing communication skills in medical examinations.