Assessing emergency medicine resident communication skills using videotaped patient encounters: Gaps in inter-rater reliability

We report on a process for assessing the communication skills of emergency medicine residents that includes 1) a faculty development initiative; 2) vi deotaping of actual resident-patient encounters in the emergency department ; and 3) creation of an observation instrument for evaluating communication behaviors. We tested this observation instrument for inter-rater reliabili ty, finding moderate-to-high agreement for only 11 of 32 items. These relat ed to personal introductions, conflict management, nonverbal communication, and overall performance. There mas poor or no agreement for behaviors rela ted to establishing rapport, gathering information, and contracting or info rming, Challenges of assessing interpersonal skills of emergency medicine r esidents are discussed. (C) 1999 Elsevier Science Inc.