Cross-cultural adaptation of the 4-Habits Coding Scheme into French to assess physician communication skills.


Journal

PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081

Informations de publication

Date de publication:
2020
Historique:
received: 04 09 2019
accepted: 05 03 2020
entrez: 17 4 2020
pubmed: 17 4 2020
medline: 3 7 2020
Statut: epublish

Résumé

The Four Habits Coding Scheme (4-HCS) is a standardized instrument designed to assess physicians' communication skills from an external rater's perspective, based on video-recorded consultations. To perform the cross-cultural adaptation of the 4-HCS into French and to assess its psychometric properties. The 4-HCS was cross-culturally adapted by conducting forward and backward translations with independent translators, following international guidelines. Four raters rated 200 video-recorded medical student consultations with standardized patients, using the French version of the 4-HCS. We examined the internal consistency, factor structure, construct validity, and reliability of the 4-HCS. The mean overall 4-HCS score was 76.44 (standard deviation, 12.34), with no floor or ceiling effects across subscales. The median rating duration of rating was 8 min (range, 4-19). Cronbach's alpha was 0.94 for the overall 4-HCS, ranging from 0.72 to 0.88 across subscales. In confirmatory factor analysis, goodness-of-fit statistics did not corroborate the hypothesized 4-habit structure. Exploratory factor analysis resulted in two dimensions, with the merging of three conceptually related habits into a single dimension and substantial cross-loading for 15 out of 23 items. Median average absolute-agreement intra-class correlation coefficient estimates were 0.74 (range, 0.68-0.84) and 0.85 (range, 0.76-0.91) for inter- and intra-rater reliability of habit subscales, respectively. The French version of the 4-HCS demonstrates satisfactory internal consistency but requires the use of two independent raters to achieve acceptable reliability. The underlying factor structure of the original US version and cross-cultural adaptations of the 4-HCS deserve further investigation.

Sections du résumé

BACKGROUND
The Four Habits Coding Scheme (4-HCS) is a standardized instrument designed to assess physicians' communication skills from an external rater's perspective, based on video-recorded consultations.
OBJECTIVE
To perform the cross-cultural adaptation of the 4-HCS into French and to assess its psychometric properties.
METHODS
The 4-HCS was cross-culturally adapted by conducting forward and backward translations with independent translators, following international guidelines. Four raters rated 200 video-recorded medical student consultations with standardized patients, using the French version of the 4-HCS. We examined the internal consistency, factor structure, construct validity, and reliability of the 4-HCS.
RESULTS
The mean overall 4-HCS score was 76.44 (standard deviation, 12.34), with no floor or ceiling effects across subscales. The median rating duration of rating was 8 min (range, 4-19). Cronbach's alpha was 0.94 for the overall 4-HCS, ranging from 0.72 to 0.88 across subscales. In confirmatory factor analysis, goodness-of-fit statistics did not corroborate the hypothesized 4-habit structure. Exploratory factor analysis resulted in two dimensions, with the merging of three conceptually related habits into a single dimension and substantial cross-loading for 15 out of 23 items. Median average absolute-agreement intra-class correlation coefficient estimates were 0.74 (range, 0.68-0.84) and 0.85 (range, 0.76-0.91) for inter- and intra-rater reliability of habit subscales, respectively.
CONCLUSION
The French version of the 4-HCS demonstrates satisfactory internal consistency but requires the use of two independent raters to achieve acceptable reliability. The underlying factor structure of the original US version and cross-cultural adaptations of the 4-HCS deserve further investigation.

Identifiants

pubmed: 32298278
doi: 10.1371/journal.pone.0230672
pii: PONE-D-19-24879
pmc: PMC7161987
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e0230672

Déclaration de conflit d'intérêts

The authors have declared that no competing interests exist

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Auteurs

Alexandre Bellier (A)

Quality of Care Unit, Grenoble Alpes University Hospital, Grenoble, France.
School of Medicine, Grenoble Alpes University, Grenoble, France.
Computational and Mathematical Biology Team, TIMC-IMAG, UMR 5525, CNRS, Grenoble Alpes University, Grenoble, France.
CIC 1406, INSERM, Grenoble Alpes University, Grenoble, France.

Philippe Chaffanjon (P)

School of Medicine, Grenoble Alpes University, Grenoble, France.

Edward Krupat (E)

Center for Evaluation, Harvard Medical School, Harvard University, Boston, Massachusetts, United States of America.

Patrice Francois (P)

Quality of Care Unit, Grenoble Alpes University Hospital, Grenoble, France.

José Labarère (J)

Quality of Care Unit, Grenoble Alpes University Hospital, Grenoble, France.
School of Medicine, Grenoble Alpes University, Grenoble, France.
Computational and Mathematical Biology Team, TIMC-IMAG, UMR 5525, CNRS, Grenoble Alpes University, Grenoble, France.
CIC 1406, INSERM, Grenoble Alpes University, Grenoble, France.

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