Development and validation of a family meeting assessment tool (FMAT)

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HAGIWARA, Yuya | HEALY, Jennifer | LEE, Shuko | ROSS, Jeanette | FISCHER, Dixie | SANCHEZ-REILLY, Sandra

CONTEXT: A cornerstone procedure in Palliative Medicine is to perform family meetings. Learning how to lead a family meeting is an important skill for physicians and others who care for patients with serious illnesses and their families. There is limited evidence on how to assess best practice behaviors during end of life family meetings. OBJECTIVES: Our aim was to develop and validate an observational tool to assess trainees' ability to lead a simulated end-of-life family meeting. METHODS: Building on evidence from published studies and accrediting agency guidelines, an expert panel at our institution developed the Family Meeting Assessment Tool. All fourth-year medical students and eight geriatric & palliative medicine fellows were invited to participate in a Family Meeting Objective Structured Clinical Exam, where each trainee assumed the physician role leading a complex family meeting. Two evaluators observed and rated randomly chosen students' performances using the Family Meeting Assessment Tool during the exam. Inter-rater reliability was measured using percent agreement. Internal consistency was measured using Cronbach's alpha. RESULTS: A total of 141 trainees (MS4=133, GPF=8) and 26 interdisciplinary evaluators participated in the study. Internal reliability (Cronbach's alpha) of the tool was 0.85. Number of trainees rated by two evaluators was 210 (MS4=202, GPF=8). Rater agreement was 84%. Composite scores, on average, were significantly higher for fellows than for medical students (p <0.001). CONCLUSION: Expert-based content, high inter-rater reliability, good internal consistency and ability to predict educational level provided initial evidence for construct validity for this novel assessment tool.

http://dx.doi.org/10.1016/j.jpainsymman.2017.07.048

Voir la revue «JOURNAL OF PAIN AND SYMPTOM MANAGEMENT, 55»

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