Measuring clinical skills in agenda-mapping (EAGL-I)

Area of Science:

• Medical Education
• Clinical Skills Assessment
• Communication Skills Training

Background:

• Effective patient-centered communication is crucial in medical practice.
• Agenda-mapping, understanding and addressing patient concerns, is a key communication skill.
• Existing tools for measuring agenda-mapping skills are limited.

Purpose of the Study:

• To develop and validate the Evaluation of AGenda-mapping skilL Instrument (EAGL-I).
• To assess the reliability and validity of EAGL-I in measuring medical students' agenda-mapping abilities.
• To determine if EAGL-I can detect changes in skills after training and predict patient agenda disclosure.

Main Methods:

• The EAGL-I was developed through literature review and piloting.
• Simulated patient consultations were recorded with third-year medical students before and after teaching.
• Three raters used EAGL-I to assess student agenda-mapping, with reliability and change detection analyzed.

Main Results:

• EAGL-I demonstrated reliable assessment of agenda-mapping (Ep(2)=0.832; φ=0.675).
• The instrument showed acceptable generalizability across items and raters.
• Significant improvements in agenda-mapping scores were observed post-teaching, and scores predicted the expression of hidden patient agendas.

Conclusions:

• The EAGL-I is a validated and reliable instrument for measuring agenda-mapping skills.
• The tool is sensitive to changes in skills after targeted teaching.
• EAGL-I can predict the likelihood of patients disclosing their full agenda in simulated settings.