Comprehension of Patient-Physician Interaction through Analysis of Relationships between Domains in Clinical Performance Examination

This research investigated the psychometric properties of the patient-physician interaction (PPI) domain in the clinical performance examination (CPX). This research aimed to understand the PPI domain in the CPX through a psychometric and relationship analysis between the domains.

Data were drawn from 1,302 examinees on a set of 6 common CPX cases and 1,066 on a 'bad news delivery' case. All cases included 7 PPI items, among which we calculated internal consistency reliability. Correlations were made between PPI and the other domains. Analyses using the structural equation model (SEM) were conducted to assess the relationships between latent factors and controlled measurement errors. To calculate the disparity between colleges, we performed a multi-level analysis. Also, we conducted t-tests to investigate the consistency of the PPI and information sharing (IS) scores in the 'bad news delivery' case.

Correlation between the mean PPI score and the total CPX score was high (0.707). The correlations between PPI and other domains were; 0.904 for the patient's overall satisfaction, 0.41 for history taking, and 0.327 for patient education. In SEM, these correlations between latent variables increased. The proportion of level-2 (between-school component) variance in PPI was 4.1%. For 'bad news delivery', the group that checked 'yes' on the IS items had higher PPI scores (mostly p<0.01).

PPI is an influential domain of the CPX and is highly related with the patient's overall satisfaction, clinical courtesy, and history taking. Disparities between schools in PPI are relatively small, such that the PPI could be due to individual factors rather than the school.