Using the Communication Assessment Tool (CAT) to Assess Communication
Skills ofFamily Medicine Residents
Linda Myerholtz, Ph.D., Lynn Simons , Psy.D. , Sumi Felix, M.D., Tuan Nguyen, M.D. , Julie
Brennan, Ph.D., Ana Rivera-Tovar, Ph.D., Pat Martin, PCC, Jeri Hepworth, Ph.D., Gregory
Makoul, Ph.D.
CAT 14-item patient satisfaction survey
Physician interpersonal and communication skills
Development based on sound psychometric methods
5-point rating scale: 1 = poor 2 = fair 3 = good 4 = very good 5 = excellent
Paper and pencil, phone, internet administration
Makoul G, Krupat E, Chang C. Measuring patient views of physician communication skills: Development and testing of the Communication Assessment Tool. Patient Educ Couns 2007; 67:333-342.
Individualized Resident Sample ReportYour
ResultsMean Results for all Mercy
FM Residents
National Sample
[Makoul, et al (2007) n = 950
Overall Mean Score 4.59 4.56 4.68 Standard Deviation 0.49 0.64 0.54Mean % of Items Rated as Excellent
64.78% 68.09% 76.30% Standard Deviation 6.54% 3.08% 11.10%
Mean Percent of Items Rated as "Excellent"
0%10%20%30%40%50%60%70%80%90%
1. G
reet
ed m
e in
a w
ay th
at m
ade
me
feel
com
forta
ble
2. T
reat
ed m
e w
ith re
spec
t
3. S
how
ed in
tere
st in
my
idea
s ab
out
my
heal
th
4. U
nder
stoo
d m
y m
ain
heal
th
conc
erns
5. P
aid
atte
ntio
n to
me
(look
ed a
t me,
liste
ned
care
fully
)
6. L
et m
e ta
lk w
ithou
t int
erru
ptio
ns
7. G
ave
me
as m
uch
info
rmat
ion
as I
wan
ted
8. T
alke
d in
term
s I c
ould
und
erst
and
9. C
heck
ed to
be
sure
I un
ders
tood
ever
ythi
ng
10.
Enco
urag
ed m
e to
ask
que
stio
ns
11.
Invo
lved
me
in d
ecis
ions
as
muc
h
as I
wan
ted
12.
Dis
cuss
ed n
ext s
teps
, inc
ludi
ng
any
follo
w-u
p pl
ans
13.
Show
ed c
are
and
conc
ern
14.
Spen
t the
righ
t am
ount
of t
ime
with
me O
VER
ALL
MEA
N
Resident X Mercy FM Overall Nov 2008 PGY2 Nov 2008
Objectives
Gather benchmarking data for the use of the CAT in Family Medicine residency programs
Examine differences based on: Year in training Native language of the resident (native English
speaking vs. non-native English speaking) Gender
Sample & Methods Six Family Medicine residency programs
Midwest & East coast Urban, suburban, rural communities 13-38 residents per program
127 residents
Data Collection: Nov 2008- Dec 2008 Paper and pencil version of the CAT
1,880 complete/useable surveys
Scoring: Mean ratings
Overall
By item
Percentage of “Excellent” ratings
Overall
By Item
Demographic Characteristics of Residents
% n
Gender: Male 44.1% 56
Female 55.9% 71
PGY Training Year: PGY 1 34.6% 44 PGY 2 30.0% 38 PGY 3 35.4% 45
Native English Speaking: Yes 56.7% 72 No 43.3% 55
Mean (SD) Minimum Maximum Age: 32.4 (5.8) 25 51
Results Overall mean percent “excellent” = 69.7% (SD = 40.4)
Items rated most frequently as “excellent” Paid attention to me (73.6%) Treated me with respect (72.8%) Showed care and concern (72.6%)
Items rated least frequently as “excellent” Encouraged me to ask questions (63.2%) Involved me in decisions (64.9%)
Consistent with Makoul et al.’s findings for practicing physicians
Training Year
Overall p = .015 PGY 1 vs. PGY 2 p =.018 ; PGY 1 vs. PGY 3 = p =.004 ; PGY 2 vs. PGY 3 = p = .55
77.0%
69.5%68.1%
60.0%
65.0%
70.0%
75.0%
80.0%
PGY 1 PGY 2 PGY 3
Overall Percent Rated as Excellent
Native Language
p = .06
71.8%
67.1%
60.0%
65.0%
70.0%
75.0%
80.0%
English Non-native English
Overall Percent Rated as Excellent
Gender
p = .81
69.2% 70.1%
60.0%
65.0%
70.0%
75.0%
80.0%
Male Female
Overall Percent Rated as Excellent
Limitations
Sample = Convenience sample of volunteering programs
Variability in the number of surveys collected per resident
Advantages
Measures patient’s perspective
User friendly administration & scoring
Provides empirical measure of core ACGME competency
Differentiates between residents
Easy to track changes over time
Benchmark data now available
Lessons Learned & Future Needs
Increase sample sizes
Evaluate changes over time
Consider efficacy of a minimum passing score 58% has been recommended2
Continue to expand benchmarking data
2 Wayne D, Cohen E, Makoul G, McGaghie W. The impact of judge selection on standard setting for a patient survey of physician communication skills. Acad Med 2008; 83: S17-20.