Abstract
Empathy has been shown to affect the quality of care by enhancing the physician–patient relationship and promoting effective communication. In this study, the newly developed Rating Scales for the Assessment of Empathic Communication in Medical Interviews (REM), designed to assess empathy and confrontation in physician–patient interactions, were subjected to preliminary psychometric testing. Particular attention was paid to face validity, reliability, sensitivity, and practicality. A total of 118 volunteers were asked to assess transcribed interactions between physicians and a standardized patient using the REM. In order to assess the convergent validity of the REM, the Motivational Interviewing Treatment Integrity Code (MITI) and the Behavior Change Counseling Index (BECCI) were used. Factor analysis identified two subscales, reflecting empathy and confrontation. Interrater reliability coefficients for items ranged from r = .82 to .97; Cronbach’s alphas for the two subscales were .89 and .88, respectively. The convergent validity was supported by substantial correlations between the REM scores and the MITI scores and by significant correlations between the REM scores and the BECCI score. The REM demonstrated good psychometric properties suggesting the rating scales might be useful in clinical practice, research endeavors, and medical education. Further research is necessary to assess the test-retest reliability as well as the predictive validity of this instrument.
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Acknowledgments
This research was supported by the German Federal Ministry of Education and Research (grant no. 01EB0131). The authors wish to thank Kelley Kucaba for her helpful comments on drafts of this article and the students of the winter class 2003 for their assistance with the study.
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Appendix
Appendix
¼/SimplePara>
(2) Did the physician treat the patient as an equal partner? | |
1 - - 2 - - 3 - - 4 - - 5 - - 6 - - 7 | |
not equal | completely equal |
¼/SimplePara>
(3) Did the physician show understanding of the patient’s point of view? | |
1 - - 2 - - 3 - - 4 - - 5 - - 6 - - 7 | |
no understanding | a lot of understanding |
¼/SimplePara>
(4) Did the physician try to put him/herself in the position of the patient? | |
1 - - 2 - - 3 - - 4 - - 5 - - 6 - - 7 | |
not at all | a lot |
¼/SimplePara>
(5) Did the physician show interest in the patient’s opinion? | |
1 - - 2 - - 3 - - 4 - - 5 - - 6 - - 7 | |
no interest | a lot of interest |
¼/SimplePara>
(6) Did the physician put the patient under pressure? | |
1 - - 2 - - 3 - - 4 - - 5 - - 6 - - 7 | |
no pressure | a lot of pressure |
¼/SimplePara>
(7) Did the physician “preach”? | |
1 - - 2 - - 3 - - 4 - - 5 - - 6 - - 7 | |
did not “preach” | “preached” a lot |
¼/SimplePara>
(8) Did the physician admonish the patient? | |
1 - - 2 - - 3 - - 4 - - 5 - - 6 - - 7 | |
not at all | a lot |
¼/SimplePara>
(9) Was the physician responsive to the patient? | |
1 - - 2 - - 3 - - 4 - - 5 - - 6 - - 7 | |
not responsive | very responsive |
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Nicolai, J., Demmel, R. & Hagen, J. Rating Scales for the Assessment of Empathic Communication in Medical Interviews (REM): Scale Development, Reliability, and Validity. J Clin Psychol Med Settings 14, 367–375 (2007). https://doi.org/10.1007/s10880-007-9081-8
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DOI: https://doi.org/10.1007/s10880-007-9081-8