Two-dimensional structure of the MAAS-Global rating list for consultation skills of doctors

Background: The MAAS-Global (MG) is widely used to assess doctor-patient communication skills. Reliability and validity have been investigated, but little is known about its dimensionality. Assuming physicians tend to adopt certain styles or preferences in their communication with patients, a multi-dimensional structure of the MG can be hypothesized. Aim: This study investigates the dimensional structure of the MG and explores the validity of this structure by studying the relationship between potential MG sub-scales and general practice speciality trainees' personal characteristics. Methods: Communication skills of 68 first-year trainees in a two-station objective structured clinical examination were assessed. Exploratory factor analysis was conducted on the resulting MG item-scores. With t-tests and correlational analysis, the relationship between MG scores and trainees' personal characteristics was examined. Results: Two well-interpretable factors were found, representing patient-oriented and task-oriented communication skills. Being born in the Netherlands and empathy were positively associated with overall communication skills. Prior communication skills training was exclusively related to task-oriented communication skills. Empathy was associated with patient-oriented, but not with task-oriented communication skills. Conclusion: The two-dimensional structure of the MG may be valuable in gaining a better understanding of factors influencing the acquisition of communication skills. This may be used to optimize teaching methods in communication skills trainin