Interpersonal Skills Questionnaire Research Articles

Improving optometry student interpersonal skills through online patient, clinician and student evaluation and feedback

ABSTRACT Clinical relevance Interpersonal skills are crucial for successful clinician-patient interactions. To prepare future optometrists for clinical practice, pedagogical evaluation is important to support the implementation of new strategies for teaching and evaluating interpersonal skills. Background Optometry students largely develop their interpersonal skills through in-person patient interactions. Telehealth is increasing, yet strategies to develop the interpersonal skills of students for teleconsulting have not been explored. This study aimed to assess the feasibility, effectiveness and perceived usefulness of an online, multisource (patients, clinicians and students) evaluation and feedback program for developing interpersonal skills. Methods Via an online teleconferencing platform, optometry students (n = 40) interacted with a volunteer patient, observed by a teaching clinician. Patients and clinicians evaluated the interpersonal skills of the student in two ways: (1) qualitative written feedback, and (2) quantitative rating (Doctors’ Interpersonal Skills Questionnaire). All students received written patient and clinician feedback after the session, but not their quantitative ratings. A subset of students (n = 19) completed two sessions, self-ratings, and were provided with their written feedback and an audiovisual recording from their first interaction before completing the second session. All participants were invited to complete an anonymous survey at program completion. Results Patient and clinician overall interpersonal skills ratings were positively correlated (Spearman’s r = 0.35, p = 0.03) and showed moderate agreement (Lin’s concordance coefficient = 0.34). Student self-ratings did not match patient ratings (r = 0.01, p = 0.98), whereas there was moderate agreement between clinician and student ratings (Lin’s concordance coefficient = 0.30). Ratings improved at the second visit (p = 0.01). Patient ratings were higher than clinicians (p = 0.01) and students (p = 0.03). All participants agreed that the program was feasible, useful and effective at fostering good interpersonal skills. Conclusion Multisource feedback about interpersonal skills contributes to improvement in student performance. Patients and clinicians can evaluate and provide useful feedback to optometry students about their interpersonal skills using online methods.

Improving optometry students’ interpersonal skills by using telehealth technology and reconnecting with the older adult community

Background: Interpersonal skills are crucial for successful clinician-patient interactions for optometrists, and an integral part of optometry competency standards (Kiely & Slater, 2015) and health professionals’ code of conduct (AHPRA, 2022). Optometry students largely develop these skills through “in-person” interactions. One pedagogical strategy to develop students’ interpersonal skills is to procure “multisource” feedback from different sources (Chandler et al., 2010, Donnon et al., 2014, Holmboe & Iobst, 2020, Stevens et al., 2018), particularly the “patient voice” (Baines et al., 2018, Bokken et al., 2010, Clever et al., 2011, Haq et al., 2006, Tattersall 2002). Patients from the community can be effectively involved in evaluating optometry students’ interpersonal skills in-person (Schmid et al., 2020). Given increased demands for telehealth and e-learning, this study aimed to assess the feasibility and utility of involving older adult volunteer patients in online interaction, evaluation and feedback provision to improve optometry students’ “online” interpersonal skills. Methods: Using Zoom, 40 student optometrists participated in a structured interaction with a de-identified patient (aged 50+), which was observed by an unidentifiable teaching clinician. Patients, teachers and students provided qualitative written feedback in response to two questions: “What two things did the student do well?” and “What two things could the student improve?”, and completed a modified version of the Doctors’ Interpersonal Skills Questionnaire (DISQ) to quantitatively evaluate interpersonal skills. A subset of students (n=19) completed two sessions. The overall DISQ scores were compared using a repeated-measures analysis of variance (RM-ANOVA). At program conclusion, all participants were invited to complete an anonymous survey about their perceived usefulness and experience of the online activity. Results: Patients gave higher overall ratings of students’ interpersonal skills than teachers (RM-ANOVA main effect of feedback source: F(1,38)=7.40, p=0.01). For the subset of students that completed two sessions, DISQ ratings from patients, teachers and students were higher for the second compared to the first session (RM-ANOVA main effect of session: F(1,54)=7.76, p=0.01). Students agreed that patient and teacher feedback was useful (97% and 93% of responses, respectively), and that they used the feedback to improve their clinical competence (100% and 93% of responses, respectively). Patients and teachers agreed that providing feedback made them feel they were helping the student learn (100% of respondents), and found it easy to give constructive comment about how the student interacted (90% of patients, 100% of teachers). However, about one-third (35%) and more than half of the students (57%) reported feeling anxious knowing that the patient and teacher, respectively, would provide feedback, while a small proportion of patients (3%) – but not teachers – felt anxious about providing feedback to students. Conclusions: This study demonstrates that involving older volunteers from the community in an online interaction is feasible and useful in improving optometry student’s interpersonal skills. This is despite eliciting some feelings of anxiousness in students, and to a lesser degree, in patients. Using telehealth technology to reconnect with the community provides an alternative avenue by which students can improve their interpersonal skills for better patient satisfaction and quality of care.

Patient feedback on hospital pharmacists' consultation skills: A feasibility study using the Interpersonal Skills Questionnaire (ISQ).

BackgroundImprovement in practitioners’ consultation skills (CSs) can be driven by patient feedback, however, to date, no study has been conducted with reference to pharmacy consultations. The Interpersonal Skills Questionnaire (ISQ) is potentially appropriate for collecting patient feedback on pharmacists’ CSs. This study aims to explore the feasibility of collecting patient feedback on hospital pharmacists’ CSs using the ISQ, to identify the acceptability of the feedback process, and to identify methods to enhance the process in the future.MethodsThe study was conducted in a teaching hospital, United Kingdom, between 2018 and 2019. A diverse sample of pharmacists with patient-facing roles was purposively selected. The study comprised three phases. Pharmacists collected feedback from patients following their consultation using the ISQ utilising a third person whenever possible (phase-1). Data analysis and individual report writing was conducted by a private company. Interviewing a sample of patient participants by telephone (phase-2), and interviewing pharmacists face-to-face after receiving feedback reports (phase-3). All interviews were transcribed verbatim and thematically analysed. The study received approval by the NHS Health Research Authority.ResultsSix pharmacists were included. Of the 119 distributed ISQs, 111 were returned (response rate 93%). Patients were mostly recruited by their consulting pharmacists (72%, n = 80). All pharmacists and 14 patients were interviewed. Participants were positive about patient feedback and its role in enhancing CSs. Most did not encounter any problem with the process, however, some pharmacists struggled to find a third person. The ISQ was mostly viewed suitable to assessing pharmacy consultations. Some reports highlighted areas to improve (e.g. protecting patient’s privacy).ConclusionsCollecting feedback is feasible, acceptable and may enhance CSs, however, the process was associated with challenges such as finding a third person. Several measures should be considered to make the process more feasible within the hospital pharmacy setting.

Involving patients in the development of interpersonal skills of optometry students

BackgroundProviding patients an opportunity to give feedback to optometry students on their communication and interpersonal skills allows for a unique learning opportunity. The aim of the current project was to determine if the Doctors’ Interpersonal Skills Questionnaire (DISQ) was suitable for use with optometry students in a large teaching clinic and if it provided useful feedback to the students for learning purposes.MethodsThe DISQ is a 12‐item questionnaire that utilises a five‐point Likert scale; a higher score indicates better performance. The DISQ was modified for an optometry context and developed into an online questionnaire. Patients were invited to complete the survey following their consultation with a final year student. Patients provided feedback on the interpersonal skills of the student optometrist who conducted the consultation under supervision. Students were provided with both individual and collated feedback obtained for the entire student group; strategies for improving communication were discussed. This activity did not form part of the grades of the students.ResultsPatients were very satisfied with the interpersonal skills of final year optometry students. Highest scores were given for questions relating to the warmth of greeting, respect shown and time given. Lowest scores were for questions relating to explanations, reassurance and confidence. There was a significant improvement in the communication and interpersonal skills of students following the provision of patient feedback and strategies for improving these skills, and an additional period of clinical experience.ConclusionPatients can provide feedback on the interpersonal skills of optometry students using the DISQ. This feedback results in further skill development for students and makes patients feel valued within the teaching clinic environment. This activity assisted in ensuring that graduating optometrists have the interpersonal skills required to communicate clearly and effectively with patients, a requirement for practising with a patient‐centred focus.

Exploring what patients think when answering the Interpersonal Skills Questionnaire (ISQ) following a hospital pharmacist consultation: A ‘think-aloud’ study

Exploring what patients think when answering the Interpersonal Skills Questionnaire (ISQ) following a hospital pharmacist consultation: A ‘think-aloud’ study

The provision of patient-centred care: A qualitative analysis of community pharmacists’ views after consultation skills training

To identify patient feedback questionnaires that assess the development of consultation skills (CSs) of practitioners.We conducted a systematic search using seven databases from inception to January 2017 to identify self-completed patient feedback questionnaires assessing and enhancing the development of CSs of individual practitioners. Results were checked for eligibility by three authors, and disagreements were resolved by discussion. Reference lists of relevant studies and Open Grey were searched for additional studies.Of 16,312 studies retrieved, sixteen were included, describing twelve patient feedback questionnaires that were mostly designed for physicians in primary care settings. Most questionnaires had limited data regarding their psychometric properties, except for the Doctor Interpersonal Skills Questionnaire (DISQ). Most studies conducted follow-up, capturing positive views of practitioners regarding the process (n = 14). Feedback was repeated by only three studies, demonstrating different levels of improvement in practitioners’ performance.Identified questionnaires were mainly focused on physicians, however, to support using patient feedback, questionnaires need to be validated with other practitioners.Several patient feedback questionnaires are available, showing potential for supporting practitioners’ development. Valid questionnaires should be used with appropriate practitioners in developing more evidence for the impact they may have on actual consultations.

Exploring what patients think when answering the Interpersonal Skills Questionnaire (ISQ): A ‘think aloud’ study

The Interpersonal Skills Questionnaire (ISQ) was developed to collect patient feedback on consultation skills of practitioners. However, it has not yet been evaluated with pharmacists. To explore the thinking process of patients as they completed the ISQ following a consultation with a pharmacist. A qualitative think aloud (TA) methodology was used to explore patients' thinking while completing the ISQ following a consultation with a pharmacist. The study was conducted in secondary care with outpatients ≥18 years old. Interviews were carried out in rounds and were informally analysed (i.e., by writing notes while listening to recordings) to identify any associated major problem(s). Discussions were held between researchers to determine whether changes were needed based on patients' comments. Eight patients in total (50% females) participated in this study (mean age: 48 years). Three rounds of TA were conducted. Most items of the ISQ were interpreted similarly by all participants with no major problems necessitating refining the ISQ. Modification of the ISQ was unnecessary as interviews demonstrated no major problems with its use. The ISQ is thus a potentially suitable tool to collect patient feedback on pharmacists' consultations.

Searching for a written patient feedback instrument for patient-medical student consultations.

ObjectiveThe Patient Teaching Associate (PTA) program at Eastern Health Clinical School uses volunteer patients with chronic illnesses in consultation-based medical student education. The PTA program aims to develop students’ patient-centeredness and associated skills. Our study aims, 1) to identify key desirable characteristics of written patient feedback to doctors and/or students that focuses on patient-centeredness in consultations, and 2) to critically evaluate existing instruments to identify any suitable instrument for use for medical student teaching.MethodsWe reviewed our experience with the PTA program and explored the literature on patient-centeredness and patient feedback to identify desirable characteristics of written feedback for our program. A systematic search was conducted to identify existing patient feedback instruments. These were then evaluated in light of criteria based on desirable characteristics.ResultsEight instruments met the inclusion criteria. While all were designed for patient use, none were ideal for the PTA program. The Doctors’ Interpersonal Skills Questionnaire (DISQ), while not used with medical students, is the closest fit to criteria.ConclusionThe lack of instruments specifically designed for written patient feedback to medical students highlights a gap in the current literature.Practice implicationsThe DISQ provides a good basis for developing a new feedback instrument focused on patient-centeredness in medical students.

Early predictors of need for remediation in the Australian general practice training program: a retrospective cohort study.

Underperforming trainees requiring remediation may threaten patient safety and are challenging for vocational training programs. Decisions to institute remediation are high-stakes-remediation being resource-intensive and emotionally demanding on trainees. Detection of underperformance requiring remediation is particularly problematic in general (family) practice. We sought to establish early-training assessment instruments predictive of general practice (GP) trainees' subsequently requiring formal remediation. We conducted a retrospective cohort study of trainees from a large Australian regionally-based GP training organization. The outcome factor was requirement for formal remediation. Independent variables were demographic factors and a range of formative assessments conducted immediately prior to or during early-stage training. Analyses employed univariate and multivariate logistic regression of each predictor assessment modality with the outcome, adjusting for potential confounders. Of 248 trainees, 26 (10.5%) required formal remediation. Performance on the Colleague Feedback Evaluation Tool (entailing feedback from a trainee's clinical colleagues on clinical performance, communication and probity) and External Clinical Teaching Visits (half-day sessions of the trainee's clinical consultations observed directly by an experienced GP), along with non-Australian primary medical qualification, were significantly associated with requiring remediation. There was a non-significant trend for association with performance on the Doctors Interpersonal Skills Questionnaire (patient feedback on interpersonal elements of the consultation). There were no significant associations with entry-selection scores or formative exam or assessment scores. Our finding that 'in vivo' assessments of complex behaviour, but not 'in vitro' knowledge-based assessments, predict need for remediation is consistent with theoretical understanding of the nature of remediation decision-making and should inform remediation practice in GP vocational training.

Does hearing the patient perspective improve consultation skills in examinations? An exploratory randomized controlled trial in medical undergraduate education

Purpose: Medical education increasingly includes patient perspectives, but few studies look at the impact on students’ proficiency in standard examinations. We explored students’ exam performance after viewing video of patients’ experiences.Methods: Eighty-eight medical students were randomized to one of two e-learning modules. The experimental group saw video clips of patients describing their colposcopy, while the control group viewed a clinician describing the procedure. Students then completed a Multiple Choice Questionnaire (MCQ) and were assessed by a blinded clinical examiner in an Objective Structured Clinical Examination (OSCE) with a blinded simulated patient (SP). The SP scored students using the Doctors’ Interpersonal Skills Questionnaire (DISQ). Students rated the module’s effect on their skills and confidence. Regression analyses were used to compare the effect of the two modules on these outcomes, adjusting for gender and graduate entry.Results: The experimental group performed better in the OSCE than the control group (odds ratio 2.7 [95%CI 1.2–6.1]; p = 0.016). They also reported significantly more confidence in key areas, including comfort with patients’ emotions (odds ratio 6.4 [95%CI 2.7–14.9]; p < 0.0005). There were no other significant differences.Conclusion: Teaching that included recorded elements of real patient experience significantly improved students’ examination performance and confidence.

Impact of National Institutes of Health Gastrointestinal PROMIS Measures in Clinical Practice: Results of a Multicenter Controlled Trial.

The National Institutes of Health (NIH) created the Patient Reported Outcomes Measurement Information System (PROMIS) to allow efficient, online measurement of patient-reported outcomes (PROs), but it remains untested whether PROMIS improves outcomes. Here, we aimed to compare the impact of gastrointestinal (GI) PROMIS measures vs. usual care on patient outcomes. We performed a pragmatic clinical trial with an off-on study design alternating weekly between intervention (GI PROMIS) and control arms at one Veterans Affairs and three university-affiliated specialty clinics. Adults with GI symptoms were eligible. Intervention patients completed GI PROMIS symptom questionnaires on an e-portal 1 week before their visit; PROs were available for review by patients and their providers before and during the clinic visit. Usual care patients were managed according to customary practices. Our primary outcome was patient satisfaction as determined by the Consumer Assessment of Healthcare Providers and Systems questionnaire. Secondary outcomes included provider interpersonal skills (Doctors' Interpersonal Skills Questionnaire (DISQ)) and shared decision-making (9-item Shared Decision Making Questionnaire (SDM-Q-9)). There were 217 and 154 patients in the GI PROMIS and control arms, respectively. Patient satisfaction was similar between groups (P>0.05). Intervention patients had similar assessments of their providers' interpersonal skills (DISQ 89.4±11.7 vs. 89.8±16.0, P=0.79) and shared decision-making (SDM-Q-9 79.3±12.4 vs. 79.0±22.0, P=0.85) vs. This is the first controlled trial examining the impact of NIH PROMIS in clinical practice. One-time use of GI PROMIS did not improve patient satisfaction or assessment of provider interpersonal skills and shared decision-making. Future studies examining how to optimize PROs in clinical practice are encouraged before widespread adoption.

Depersonalised doctors: a cross-sectional study of 564 doctors, 760 consultations and 1876 patient reports in UK general practice

ObjectivesThe objectives of this study were to assess burnout in a sample of general practitioners (GPs), to determine factors associated with depersonalisation and to investigate its impact on doctors' consultations...

Does questionnaire-based patient feedback reflect the important qualities of clinical consultations? Context, benefits and risks

Objective To explore perceptions of clinical consultations and how they relate to questionnaire-based patient feedback. Methods Telephone interviews with 35 junior doctors and 40 general practice patients who had used the Doctors’ Interpersonal Skills Questionnaire (DISQ). Results Doctors and patients had similar views of ‘good consultations’ as relying on doctors’ listening and explaining skills. Preferences for a consultation style focused on an outcome or on the doctor–patient relationship may be independent of informational and/or affective consultation content. Respondents felt the important consultation elements were similar in different contexts, and so DISQ feedback would be useful in different settings. Benefits of feedback were identified in the form of patient empowerment and doctors’ learning. Risks were identified in the inappropriate use of feedback, both inadvertent and deliberate. Conclusion The style and content of consultations may be considered as separate dimensions, an approach that may help doctors adapt their communication appropriately to different consultations. Patient feedback focused on communication skills is appropriate, but there are potential risks. Practice implications Doctors should consider the transactional or relational preference of a patient in approaching a consultation. Patient feedback can deliver benefits to doctors and patients, but risks must be acknowledged and mitigated against.

Validation of a multi-source feedback tool for use in general practice

Feedback from colleagues and patients is a core element of the revalidation process being developed by the General Medical Council. However, there are few feedback tools which have been specifically developed and validated for doctors in primary care. This paper presents data demonstrating the reliability and validity of one such tool. The CFEP360 tool combines feedback from the Colleague Feedback Evaluation Tool (CFET) and the Doctor's Interpersonal Skills Questionnaire (DISQ). The analysis of over 10 000 completed questionnaires presented here identifies that colleague feedback is essentially two-dimensional (i.e. clinical and non-clinical skills) and that patient feedback is one-dimensional. However, items from both scales also effectively predict combined global ratings, indicating that colleagues and patients are identifying similar levels of performance as accessed by the feedback. Doctors who receive low feedback scores may require further attention, meaning the feedback potentially has diagnostic value. Reliable feedback on this tool, as indicated by this analysis, requires 14 colleague responses and 25 patient responses, figures comparable to other MSF tools if CFEP360 is to be used for a high stakes performance evaluation and possible revalidation (generalisability statistic G> or =0.80). For lower stakes performance evaluations, such as personal development, responses from 11 colleagues and 16 patients will still return reliable results (G> or =0.70).

Measuring patient satisfaction

In the September issue of BJGP, Hankins et al published a brief report1 criticising the reliability and validity of the two survey instruments which are used for measuring patient satisfaction (the (Improving Practice Questionnaire [IPQ] and the General Practice Assessment Questionnaire [GPAQ]) in general practices nationally in order to monitor the quality of services and earn QOF points. I have only been involved in the development of the IPQ and so I will restrict my comments to the reliability and validity of that instrument, and not the GPAQ. Hankins et al conducted a literature search based on the names of the questionnaires IPQ, GPAQ, and GPAS (the forerunner of GPAQ). They only found one paper about the IPQ,2 none for GPAQ and three papers for GPAS. They also hand-searched journals. If they had been more thorough, they would have discovered that the IPQ had been previously validated in Australia3 where it was known as PAIS (Practice Accreditation and Improvement Survey) and that its core consists of the 12 items that comprise another instrument called DISQ (Doctor's Interpersonal Skills Questionnaire)4–6 which, in spite of its name, can be used to assess any clinicians' capability. There are several papers demonstrating that the DISQ has validity against external criteria, for example against the assessments of College examiners.7–9 The IPQ had also been assessed …

Patient assessment of surgeons' interpersonal skills

PurposeAims to assess the surgeons' communication skills with patients in the orthopaedic department of the authors' district general hospital.Design/methodology/approachA departmental prospective audit was conducted involving all consultants and middle grade surgeons. Then authors used a validated questionnaire (Doctors' Interpersonal Skills Questionnaire (DISQ)) completed by patients and analysed independently. Feedback was obtained through individual confidential reports and a study group meeting.FindingsA total of 402 patient evaluations were received and the average interpersonal skills index was 72 per cent ranging between 55 per cent and 87 per cent. The highest scores were given for respect shown, warmth of greeting and patients' confidence in the surgeon's abilities. The lowest scores were given for time given to patients to express their concerns.Research limitations/implicationsThe research has an incomplete audit circle. A second audit is required following appropriate training to alleviate the deficiencies reported in the first audit and prove the benefit.Practical implicationsThis audit highlighted important deficiencies in our interpersonal skills that could potentially be addressed by way of targeted training. This kind of assessment should become an essential part of the annual appraisal process of all hospital doctors.Originality/valueThis paper is the first to report the results of a departmental assessment process of hospital doctors using the DISQ.

Impact of the doctors' interpersonal skills questionnaire (DISQ) in Australia, Ireland and New Zealand

Impact of the doctors' interpersonal skills questionnaire (DISQ) in Australia, Ireland and New Zealand