Cotting School

The purpose of this study was to develop and test a standardized communication skills assessment instrument for radiology. The Delphi method was used to validate the Kalamazoo Communication Skills Assessment instrument for radiology by revising and achieving consensus on the 43 items of the preexisting instrument among an interdisciplinary team of experts consisting of five radiologists and four nonradiologists (two men, seven women). Reviewers assessed the applicability of the instrument to evaluation of conversations between radiology trainees and trained actors portraying concerned parents in enactments about bad news, radiation risks, and diagnostic errors that were video recorded during a communication workshop. Interrater reliability was assessed by use of the revised instrument to rate a series of enactments between trainees and actors video recorded in a hospital-based simulator center. Eight raters evaluated each of seven different video-recorded interactions between physicians and parent-actors. The final instrument contained 43 items. After three review rounds, 42 of 43 (98%) items had an average rating of relevant or very relevant for bad news conversations. All items were rated as relevant or very relevant for conversations about error disclosure and radiation risk. Reliability and rater agreement measures were moderate. The intraclass correlation coefficient range was 0.07-0.58; mean, 0.30; SD, 0.13; and median, 0.30. The range of weighted kappa values was 0.03-0.47; mean, 0.23; SD, 0.12; and median, 0.22. Ratings varied significantly among conversations (χ26 = 1186; p < 0.0001) and varied significantly by viewing order, rater type, and rater sex. The adapted communication skills assessment instrument is highly relevant for radiology, having moderate interrater reliability. These findings have important implications for assessing the relational competencies of radiology trainees.

We examined the effects of sensory-enhanced hatha yoga on symptoms of combat stress in deployed military personnel, compared their anxiety and sensory processing with that of stateside civilians, and identified any correlations between the State-Trait Anxiety Inventory scales and the Adolescent/Adult Sensory Profile quadrants. Seventy military personnel who were deployed to Iraq participated in a randomized controlled trial. Thirty-five received 3 wk (≥9 sessions) of sensory-enhanced hatha yoga, and 35 did not receive any form of yoga. Sensory-enhanced hatha yoga was effective in reducing state and trait anxiety, despite normal pretest scores. Treatment participants showed significantly greater improvement than control participants on 16 of 18 mental health and quality-of-life factors. We found positive correlations between all test measures except sensory seeking. Sensory seeking was negatively correlated with all measures except low registration, which was insignificant. The results support using sensory-enhanced hatha yoga for proactive combat stress management.

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To explore the question of whether auditorally augmented feedback can improve the eye-hand coordination of individuals with cerebral palsy, 59 (cerebral-palsied) students (mean chronological age 14 years, 3 months) were pretested with the Southern California Motor Accuracy Test and then randomly assigned to three groups. Group 1 performed training exercises-tracing line drawings-while simultaneously receiving auditorally augmented feedback about their efforts. Group 2 performed the same training exercises without the augmented feedback. Group 3 served as controls. All subjects were post-tested with the Southern California Motor Accuracy Test, followed by a second post-test after a 3-month interval. At the first post-test, the performance of the feedback group was significantly superior to that of the other groups. At the second post-test, the performance patterns among the groups were essentially the same as the time of the first post-test, but between-group differences were no longer significant. The results of this study are discussed in both empirical and theoretical terms.