Assessing communication skills in dietetic consultations: the development of the reliable and valid DIET‐COMMS tool

BACKGROUND: There is an increasing emphasis on the development of communication skills for dietitians but few evidence‐based assessment tools available. The present study aimed to develop a dietetic‐specific, short, reliable and valid assessment tool for measuring communication skills in patient consultations: DIET‐COMMS. METHODS: A literature review and feedback from 15 qualified dietitians were used to establish face and content validity during the development of DIET‐COMMS. In total, 113 dietetic students and qualified dietitians were video‐recorded undertaking mock consultations, assessed using DIET‐COMMS by the lead author, and used to establish intra‐rater reliability, as well as construct and predictive validity. Twenty recorded consultations were reassessed by nine qualified dietitians to assess inter‐rater reliability: eight of these assessors were interviewed to determine user evaluation. RESULTS: Significant improvements in DIET‐COMMS scores were achieved as students and qualified staff progressed through their training and gained experience, demonstrating construct validity, and also by qualified staff attending a training course, indicating predictive validity (P < 0.05). An acceptable level of intra‐rater reliability (rₛ = 0.90) and a moderate level of inter‐rater reliability (r = 0.49) were demonstrated. Interviews identified many positive features and possible uses for DIET‐COMMS in both pre‐ and post‐registration settings. The need for assessor training was emphasised and how readily qualified dietitians would accept assessment of skills in practice was questioned. DISCUSSION: DIET‐COMMS is a short, user‐friendly, reliable and valid tool for measuring communication skills in patient consultations with both pre‐ and post‐registration dietitians. Additional work is required to develop a training package for assessors and to identify how DIET‐COMMS assessment can acceptably be incorporated into practice.