Communication Assessment Tool - Team (CAT-T)

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Submitted by National Center... on Oct 10, 2016 - 9:55am CDT

Instrument
Authors: 
Mercer, L.M.
Tanabe, P.
Pang, P.S.
Gisondi, M.A.
Courtney, D.M.
Engel, K.G.
Donlan, S.M.
Adams, J.G.
Makoul, G
Overview: 

The CAT-T is a patient satisfaction survey focused on the quality of communication received from a medical team during a visit to the emergency department.  "Communication" refers to the interactions between members of the health care team and the patient (not interactions among health care team members).  "Communication skills" was considered a single unitary construct undelying all of the items.  The CAT-T represents a replication of a previously studied instrument, "Communication Assessment Tool (CAT)," in which patients rated the communication skills of their attending physician.  Like the CAT, the items from the CAT-T are fairly generic and could be used across specialties and environments for quality improvement efforts.  No validity data are reported for the present study, but validity evidence from the CAT concerning content, response process, internal structure, and relationship with other variables can be found in the references below.

Link to Resources
Resource links: 

Mercer, L.M., Tanable, P., Pang, P.S., Gisondi, M.A., Courtney, D.M., Engel, K.G., Donlan, S.M., Adams, J.G., Makoul, G.  (2008).  Patient perspectives on communication with the medical team: Pilot study using the Communication Assessment Tool - Team (CAT-T).  Pt Educ Couns, 73:220-223.

The original CAT was described in: Makoul G, Krupat E, Chang CH.  (2007).  Measuring patient views of physician communication skills: development and testing of the Communication Assessment Tool. Patient Educ Couns.  Aug;67(3):333-42.

To read a peer review critique of the CAT, go to the AAMC MedEdPortal.  Type in "CAT" in the home page search box to find the tool and the critique.  Registration and login are required but free.

 

Descriptive Elements
Who is Being Assessed or Evaluated?: 
Teams
Instrument Type: 
Observer-based (e.g., rubric, rating tool, 360 degree feedback)
Notes for Type: 

Patient survey of provider care.

Source of Data: 
Patients, clients
Notes for Data Sources: 

A total of 81 out of 105 adult patients approached (22.9% refusal rate) participated in the study, which took place in an academic, urban, Level 1 trauma center.  Patients were excluded from the study if they had psychiatric issues, were critically ill, physiologically unstable, non-English speaking, or under arrest.  This was a convenience sample recruited based on research assistant availability.  Enrollment took place during eight, 10-hour shifts.

Instrument Content: 
Behaviors / skills
Notes for Content: 

The CAT-T is a replica of the Communication Assessment Tool developed by Makoul, et al. (2007).  The content of the original CAT consists of 14 patient evaluations of the quality of physicians' interpersonal communication skills and one item regarding the extent to which the doctor's staff treated them "with respect."  

For the CAT-T, the authors made minor wording changes in the instructions and in item-stems to broaden the focus from a single doctor to a medical team.  "Medical Team" was operationalized in the survey as "all the people who took care of you today."  The item referring to "the doctor's staff" in the original CAT was changed to "the front desk staff" for the CAT-T.  

Instrument Length: 

15 items, approximately 5 minutes completion time.

Item Format: 
A 5-point response scale was used to evaluate the quality of communication (1 = "poor," 5 = "excellent").
Administration: 
In this study, the CAT-T was administered in person by a research assistant just prior to a patient's discharge from the ED. They interviews took place either in the patient's bed or in a secluded hallway.
Scoring: 
Percentage scores for each of the five quality levels were computed.
Language: 
English
Norms: 
None available.
Access: 
Subscription (can be viewed in journal article)
Notes on Access: 

Contact the author to confirm permission to use.

Psychometric Elements: Evidence of Validity
Content: 
None given for the current study. In the Makoul study, the authors reported an extensive development process that included literature review, focus groups with patients, and a national telephone survey to confirm which provider communication behaviors were most important to patients.
Response Process: 
None for the current study. In the development of the original CAT, each of the 15 items was subjected to the "Lexile readability analysis," with the results corresponding to a fourth grade reading level. Writing at this level increases the likelihood that the survey is easily understood when it is self-administered. Both pilot and field testing across multiple specialties proceeded the final instrument.
Internal Structure: 
None for the current study. Cronbach's alpha for the original CAT was 0.98. Factor analysis suggested that the 14 CAT items address physician skill (excluding the staff treatment question) represent a single construct.
Relation to Other Variables: 
None for the current study. The original CAT results were associated with a patient satisfaction survey conducted by the Colorado Permanente Medical Group.
Consequential: 
None reported.
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