Modification of Calgary Cambridge for Indonesian medical students: Communication guidelines

Effective communication skill applied by doctors in the doctor-patient consultation process becomes one of important factors that can improve the consultation outcomes such as patient satisfaction, adherence to treatment and recovery process. However, effective doctor-patient communication is rarely applied in practice. Limited consultation time, patient overload, doctor burnout, and poor communication skills are among the factors that cause ineffective doctor-patient communication process. This study aimed to develop a new effective communication guideline for doctor-patient communication in Indonesia by modifying the Calgary Cambridge medical interview guide. This study uses qualitative approach within four stages: expert panel, student panel and focus group discussion, expert review, and trials. Informants were chosen purposively. Three points of high category, 24 points of middle category and 44 points of low category are resulted from expert panel stage which consists of specialist representatives from 12 clinical divisions in Dr. Moehammad Hoesin central public hospital (RSMH), Palembang, South Sumatera, Indonesia. The high and middle category were discussed by two groups of internships doctors in RSMH in student panel and focus group discussion (FGD) session. The results were validated by a doctor-patient communication expert (expert reviewer) and then tested by the internship doctors through role play at the trial stage. The final result yields eight main points and eleven effective tips of the Calgary Cambridge Guide checklist modification with five to six minutes effective consultation time. This modified guideline is appropriately applicable for doctor-patient communication in daily consultation in Indonesian practical, social and cultural context

Classification of Acute Decompensated Heart Failure: An Automated Algorithm Compared With a Physician Reviewer Panel: The Atherosclerosis Risk in Communities Study

An algorithm to classify heart failure (HF) endpoints inclusive of contemporary measures of biomarkers and echocardiography was recently proposed by an international expert panel. Our objective was to assess agreement of HF classification by this contemporaneous algorithm with that by a standardized physician reviewer panel, when applied to data abstracted from community-based hospital records

Expert Consensus Guidelines for Stocking of Antidotes in Hospitals That Provide Emergency Care

We provide recommendations for stocking of antidotes used in emergency departments (EDs). An expert panel representing diverse perspectives (clinical pharmacology, medical toxicology, critical care medicine, hematology/oncology, hospital pharmacy, emergency medicine, emergency medical services, pediatric emergency medicine, pediatric critical care medicine, poison centers, hospital administration, and public health) was formed to create recommendations for antidote stocking. Using a standardized summary of the medical literature, the primary reviewer for each antidote proposed guidelines for antidote stocking to the full panel. The panel used a formal iterative process to reach their recommendation for both the quantity of antidote that should be stocked and the acceptable timeframe for its delivery. The panel recommended consideration of 45 antidotes; 44 were recommended for stocking, of which 23 should be immediately available. In most hospitals, this timeframe requires that the antidote be stocked in a location that allows immediate availability. Another 14 antidotes were recommended for availability within 1 hour of the decision to administer, allowing the antidote to be stocked in the hospital pharmacy if the hospital has a mechanism for prompt delivery of antidotes. The panel recommended that each hospital perform a formal antidote hazard vulnerability assessment to determine its specific need for antidote stocking. Antidote administration is an important part of emergency care. These expert recommendations provide a tool for hospitals that offer emergency care to provide appropriate care of poisoned patients

Examining the Impact of a Consensus Approach to Content Alignment Studies

Although both content alignment and standard-setting procedures rely on content-expert panel judgements, only the latter employs discussion among panel members. This study employed a modified form of the Webb methodology to examine content alignment for twelve tests administered as part of the Massachusetts Comprehensive Assessment System (MCAS). This modification required panel members to discuss items for which there was no consensus regarding the item’s depth of knowledge or targeted standard. After the discussion, panel members were allowed to change their original ratings. The number of changes that occurred were analyzed considering the number of items discussed and the size of the panel. Moreover, we evaluated the impact these changes had on the overall judgments of alignment as reported by Webb’s Web Alignment Tool (WAT). Findings suggest that discussion among panel members between rating rounds positively increased agreement among panel members’ ratings but had minimal effects on the overall judgments of content alignment for 11 of the 12 tests evaluated