Geurt Essers - Academia.edu (original) (raw)

Papers by Geurt Essers

Research paper thumbnail of De communicatietoets en de context van het consult

Huisarts en wetenschap, 2015

Research paper thumbnail of How do trained raters take context factors into account when assessing GP trainee communication performance? An exploratory, qualitative study

Advances in Health Sciences Education, May 24, 2014

Communication assessment in real-life consultations is a complex task. Generic assessment instrum... more Communication assessment in real-life consultations is a complex task. Generic assessment instruments help but may also have disadvantages. The generic nature of the skills being assessed does not provide indications for context-specific behaviour required in practice situations; context influences are mostly taken into account implicitly. Our research questions are: 1. What factors do trained raters observe when rating workplace communication? 2. How do they take context factors into account when rating communication performance with a generic rating instrument? Nineteen general practitioners (GPs), trained in communication assessment with a generic rating instrument (the MAAS-Global), participated in a think-aloud protocol reflecting concurrent thought processes while assessing videotaped real-life consultations. They were subsequently interviewed to answer questions explicitly asking them to comment on the influence of predefined contextual factors on the assessment process. Results from both data sources were analysed. We used a grounded theory approach to untangle the influence of context factors on GP communication and on communication assessment. Both from the think-aloud procedure and from the interviews we identified various context factors influencing communication, which were categorised into doctor-related (17), patient-related (13), consultation-related (18), and education-related factors (18). Participants had different views and practices on how to incorporate context factors into the GP(-trainee) communication assessment. Raters acknowledge that context factors may affect communication in GP consultations, but struggle with how to take contextual influences into account when assessing communication performance in an educational context. To assess practice situations, raters need extra guidance on how to handle specific contextual factors.

Research paper thumbnail of How do trained raters take context factors into account when assessing GP trainee communication performance? An exploratory, qualitative study

Advances in health sciences education : theory and practice, 2015

Communication assessment in real-life consultations is a complex task. Generic assessment instrum... more Communication assessment in real-life consultations is a complex task. Generic assessment instruments help but may also have disadvantages. The generic nature of the skills being assessed does not provide indications for context-specific behaviour required in practice situations; context influences are mostly taken into account implicitly. Our research questions are: 1. What factors do trained raters observe when rating workplace communication? 2. How do they take context factors into account when rating communication performance with a generic rating instrument? Nineteen general practitioners (GPs), trained in communication assessment with a generic rating instrument (the MAAS-Global), participated in a think-aloud protocol reflecting concurrent thought processes while assessing videotaped real-life consultations. They were subsequently interviewed to answer questions explicitly asking them to comment on the influence of predefined contextual factors on the assessment process. Resu...

Research paper thumbnail of Context factors in consultations of general practitioner trainees and their impact on communication assessment in the authentic setting

Patient Education and Counseling, 2013

and sharing with colleagues.

Research paper thumbnail of Context factors in general practitioner - patient encounters and their impact on assessing communication skills - an exploratory study

BMC Family Practice, 2013

Background: Assessment of medical communication performance usually focuses on rating generically... more Background: Assessment of medical communication performance usually focuses on rating generically applicable, well-defined communication skills. However, in daily practice, communication is determined by (specific) context factors, such as acquaintance with the patient, or the presented problem. Merely valuing the presence of generic skills may not do justice to the doctor's proficiency. Our aim was to perform an exploratory study on how assessment of general practitioner (GP) communication performance changes if context factors are explicitly taken into account. Methods: We used a mixed method design to explore how ratings would change. A random sample of 40 everyday GP consultations was used to see if previously identified context factors could be observed again. The sample was rated twice using a widely used assessment instrument (the MAAS-Global), first in the standard way and secondly after context factors were explicitly taken into account, by using a context-specific rating protocol to assess communication performance in the workplace. In between first and second rating, the presence of context factors was established. Item score differences were calculated using paired sample t-tests. Results: In 38 out of 40 consultations, context factors prompted application of the context-specific rating protocol. Mean overall score on the 7-point MAAS-Global scale increased from 2.98 in standard to 3.66 in the context-specific rating (p < 0.00); the effect size for the total mean score was 0.84. In earlier research the minimum standard score for adequate communication was set at 3.17. Conclusions: Applying the protocol, the mean overall score rose above the level set in an earlier study for the MAAS-Global scores to represent 'adequate GP communication behaviour'. Our findings indicate that incorporating context factors in communication assessment thus makes a meaningful difference and shows that context factors should be considered as 'signal' instead of 'noise' in GP communication assessment. Explicating context factors leads to a more deliberate and transparent rating of GP communication performance.

Research paper thumbnail of Identifying context factors explaining physician's low performance in communication assessment: an explorative study in general practice

BMC Family Practice, 2011

Background: Communication is a key competence for health care professionals. Analysis of registra... more Background: Communication is a key competence for health care professionals. Analysis of registrar and GP communication performance in daily practice, however, suggests a suboptimal application of communication skills. The influence of context factors could reveal why communication performance levels, on average, do not appear adequate. The context of daily practice may require different skills or specific ways of handling these skills, whereas communication skills are mostly treated as generic. So far no empirical analysis of the context has been made. Our aim was to identify context factors that could be related to GP communication.

Research paper thumbnail of Mixed messages in learning communication skills? Students comparing role model behaviour in clerkships with formal training

Medical Teacher, 2012

Background: Medical students learn professional communication through formal training and in clin... more Background: Medical students learn professional communication through formal training and in clinical practice. Physicians working in clinical practice have a powerful influence on student learning. However, they may demonstrate communication behaviours not aligning with recommendations in training programs. Aims: This study aims to identify more precisely what differences students perceive between role model communication behaviour during clerkships and formal training. Method: In a cross-sectional study, data were collected about physicians' communication performance as perceived by students. Students filled out a questionnaire in four different clerkships in their fourth and fifth year. Results: Just over half of the students reported communication similar to formal training. This was especially true for students in the later clerkships ( paediatrics and primary care). Good examples were seen in providing information corresponding to patients' needs and in shared decision making, although students often noted that in fact the doctor made the decision. Bad examples were observed in exploring cognitions and emotions, and in providing information meeting patient's pace. Conclusions: Further study is needed on actual physician behaviour in clinical practice. From our results, we conclude that students need help in reflecting on and learning from the gap in communication patterns they observe in training versus clinical practice.

Research paper thumbnail of De communicatietoets en de context van het consult

Huisarts en wetenschap, 2015

Research paper thumbnail of How do trained raters take context factors into account when assessing GP trainee communication performance? An exploratory, qualitative study

Advances in Health Sciences Education, May 24, 2014

Communication assessment in real-life consultations is a complex task. Generic assessment instrum... more Communication assessment in real-life consultations is a complex task. Generic assessment instruments help but may also have disadvantages. The generic nature of the skills being assessed does not provide indications for context-specific behaviour required in practice situations; context influences are mostly taken into account implicitly. Our research questions are: 1. What factors do trained raters observe when rating workplace communication? 2. How do they take context factors into account when rating communication performance with a generic rating instrument? Nineteen general practitioners (GPs), trained in communication assessment with a generic rating instrument (the MAAS-Global), participated in a think-aloud protocol reflecting concurrent thought processes while assessing videotaped real-life consultations. They were subsequently interviewed to answer questions explicitly asking them to comment on the influence of predefined contextual factors on the assessment process. Results from both data sources were analysed. We used a grounded theory approach to untangle the influence of context factors on GP communication and on communication assessment. Both from the think-aloud procedure and from the interviews we identified various context factors influencing communication, which were categorised into doctor-related (17), patient-related (13), consultation-related (18), and education-related factors (18). Participants had different views and practices on how to incorporate context factors into the GP(-trainee) communication assessment. Raters acknowledge that context factors may affect communication in GP consultations, but struggle with how to take contextual influences into account when assessing communication performance in an educational context. To assess practice situations, raters need extra guidance on how to handle specific contextual factors.

Research paper thumbnail of How do trained raters take context factors into account when assessing GP trainee communication performance? An exploratory, qualitative study

Advances in health sciences education : theory and practice, 2015

Communication assessment in real-life consultations is a complex task. Generic assessment instrum... more Communication assessment in real-life consultations is a complex task. Generic assessment instruments help but may also have disadvantages. The generic nature of the skills being assessed does not provide indications for context-specific behaviour required in practice situations; context influences are mostly taken into account implicitly. Our research questions are: 1. What factors do trained raters observe when rating workplace communication? 2. How do they take context factors into account when rating communication performance with a generic rating instrument? Nineteen general practitioners (GPs), trained in communication assessment with a generic rating instrument (the MAAS-Global), participated in a think-aloud protocol reflecting concurrent thought processes while assessing videotaped real-life consultations. They were subsequently interviewed to answer questions explicitly asking them to comment on the influence of predefined contextual factors on the assessment process. Resu...

Research paper thumbnail of Context factors in consultations of general practitioner trainees and their impact on communication assessment in the authentic setting

Patient Education and Counseling, 2013

and sharing with colleagues.

Research paper thumbnail of Context factors in general practitioner - patient encounters and their impact on assessing communication skills - an exploratory study

BMC Family Practice, 2013

Background: Assessment of medical communication performance usually focuses on rating generically... more Background: Assessment of medical communication performance usually focuses on rating generically applicable, well-defined communication skills. However, in daily practice, communication is determined by (specific) context factors, such as acquaintance with the patient, or the presented problem. Merely valuing the presence of generic skills may not do justice to the doctor's proficiency. Our aim was to perform an exploratory study on how assessment of general practitioner (GP) communication performance changes if context factors are explicitly taken into account. Methods: We used a mixed method design to explore how ratings would change. A random sample of 40 everyday GP consultations was used to see if previously identified context factors could be observed again. The sample was rated twice using a widely used assessment instrument (the MAAS-Global), first in the standard way and secondly after context factors were explicitly taken into account, by using a context-specific rating protocol to assess communication performance in the workplace. In between first and second rating, the presence of context factors was established. Item score differences were calculated using paired sample t-tests. Results: In 38 out of 40 consultations, context factors prompted application of the context-specific rating protocol. Mean overall score on the 7-point MAAS-Global scale increased from 2.98 in standard to 3.66 in the context-specific rating (p < 0.00); the effect size for the total mean score was 0.84. In earlier research the minimum standard score for adequate communication was set at 3.17. Conclusions: Applying the protocol, the mean overall score rose above the level set in an earlier study for the MAAS-Global scores to represent 'adequate GP communication behaviour'. Our findings indicate that incorporating context factors in communication assessment thus makes a meaningful difference and shows that context factors should be considered as 'signal' instead of 'noise' in GP communication assessment. Explicating context factors leads to a more deliberate and transparent rating of GP communication performance.

Research paper thumbnail of Identifying context factors explaining physician's low performance in communication assessment: an explorative study in general practice

BMC Family Practice, 2011

Background: Communication is a key competence for health care professionals. Analysis of registra... more Background: Communication is a key competence for health care professionals. Analysis of registrar and GP communication performance in daily practice, however, suggests a suboptimal application of communication skills. The influence of context factors could reveal why communication performance levels, on average, do not appear adequate. The context of daily practice may require different skills or specific ways of handling these skills, whereas communication skills are mostly treated as generic. So far no empirical analysis of the context has been made. Our aim was to identify context factors that could be related to GP communication.

Research paper thumbnail of Mixed messages in learning communication skills? Students comparing role model behaviour in clerkships with formal training

Medical Teacher, 2012

Background: Medical students learn professional communication through formal training and in clin... more Background: Medical students learn professional communication through formal training and in clinical practice. Physicians working in clinical practice have a powerful influence on student learning. However, they may demonstrate communication behaviours not aligning with recommendations in training programs. Aims: This study aims to identify more precisely what differences students perceive between role model communication behaviour during clerkships and formal training. Method: In a cross-sectional study, data were collected about physicians' communication performance as perceived by students. Students filled out a questionnaire in four different clerkships in their fourth and fifth year. Results: Just over half of the students reported communication similar to formal training. This was especially true for students in the later clerkships ( paediatrics and primary care). Good examples were seen in providing information corresponding to patients' needs and in shared decision making, although students often noted that in fact the doctor made the decision. Bad examples were observed in exploring cognitions and emotions, and in providing information meeting patient's pace. Conclusions: Further study is needed on actual physician behaviour in clinical practice. From our results, we conclude that students need help in reflecting on and learning from the gap in communication patterns they observe in training versus clinical practice.