Rating a Physician by Adolescents Using the Structured Communication Adolescent Guide (SCAG)

Abstract

The Structured Communication Adolescent Guide (SCAG) is a 29-item checklist used for teaching and assessing the adolescent clinical interview. The SCAG is divided into four sections (Getting Started, Gathering Information, Teen Alone [including lifestyles] and Wrap Up) each with a General Rating. The SCAG has been shown to be both reliable and valid when used by adolescents who have been trained in its use. We investigated the feasibility and reliability of the SCAG when used by Junior High School adolescents who had not been formally trained to use the SCAG. Methods: Participants (adolescents from three Junior High Schools) used the SCAG to score a physician in a videotaped interview with an adolescent and a mother standardized patient (SP) pair. Participants were asked to score the physician as if they were the adolescent in the video. Participants then completed a questionnaire about their experience using the SCAG. A Gold Standard SCAG score for the videotaped interview was created by a group of adolescent SP’s, a medical educator and a standardized patient trainer. Results: The Junior High School adolescents (N = 183, mean age = 13.40 years +/.51) included males (N = 94) and females (N = 89). No significant difference in SCAG scores were detected when analyzed across participant’s age, sex, and/or school. Reliability for the SCAG total scores (0.85) and General Ratings (0.73) were high. The Gold Standard scores agreed well with the participants’ scores. Participants also reported that the SCAG dealt with many issues that they felt were important to teen health and well being; and that the SCAG was clear and easy to use. Conclusion: The SCAG can be reliably used by Junior High School adolescents when watching a patient-physician interview. As these adolescents were untrained in using the SCAG and not SPs, the SCAG may be a useful tool to use on the wards, in outpatients or in a physician’s office with adolescent patients. This could provide an additional source of feedback for learners and practicing physicians.