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Development and evaluation of the "BRISK Scale," a brief observational measure of risk communication competence
Paul K J Han1, Katherine Joekes2, Greg Mills3
1Center for Outcomes Research and Evaluation, Maine Medical Center, Portland, ME, United States; Tufts University Clinical and Translational Sciences Institute, Boston, MA, United States.
Objective:
To develop and evaluate a brief observational measure of clinical risk communication competence.
Methods:
A 4-item checklist-type measure, the BRISK (Brief Risk Information Skill) Scale, was developed by selecting and refining items from a more comprehensive measure of clinical risk communication competence. Six volunteer raters received brief training on the measure and then used the BRISK Scale to evaluate 52 video-recorded encounters between 2nd-year medical students and standardized patients conducted as part of an Observed Structured Clinical Examination (OSCE) involving a risk communication task. Internal consistency reliability, inter-rater reliability, and criterion validity were assessed.
Results:
Raters reported no difficulties using the BRISK Scale; scores across all raters and subjects ranged from 0 to 16 with a mean score of 6.49 (SD=3.17). The BRISK Scale showed good internal consistency reliability (α=0.64), and inter-rater reliability at the scale level (Intraclass Correlation Coefficient (ICC)=0.79 for consistency, and 0.75 for absolute agreement) and individual-item level (ICC range: 0.62-.91). Novice raters' BRISK Scale scores were highly correlated (r=0.84, p<0.01) with expert raters' scores on the Risk Communication Content measure, a more comprehensive measure of risk communication competence.
Conclusions:
The BRISK Scale is a promising new brief observational measure of clinical risk communication competence.
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