Development and evaluation of the "BRISK Scale," a brief observational measure of risk communication competence.

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Patient education and counseling

MeSH Headings

Adolescent, Adult, Clinical Competence, Communication, Decision Making, Education, Medical, Undergraduate, Educational Measurement, Female, Humans, Male, Observer Variation, Physical Examination, Psychometrics, Reproducibility of Results, Risk, Students, Medical, Video Recording, Young Adult


OBJECTIVE: To develop and evaluate a brief observational measure of clinical risk communication competence.

METHODS: A 4-item checklist-type measure, the BRISK (Brief Risk Information Skill) Scale, was developed by selecting and refining items from a more comprehensive measure of clinical risk communication competence. Six volunteer raters received brief training on the measure and then used the BRISK Scale to evaluate 52 video-recorded encounters between 2nd-year medical students and standardized patients conducted as part of an Observed Structured Clinical Examination (OSCE) involving a risk communication task. Internal consistency reliability, inter-rater reliability, and criterion validity were assessed.

RESULTS: Raters reported no difficulties using the BRISK Scale; scores across all raters and subjects ranged from 0 to 16 with a mean score of 6.49 (SD=3.17). The BRISK Scale showed good internal consistency reliability (α=0.64), and inter-rater reliability at the scale level (Intraclass Correlation Coefficient (ICC)=0.79 for consistency, and 0.75 for absolute agreement) and individual-item level (ICC range: 0.62-.91). Novice raters' BRISK Scale scores were highly correlated (r=0.84, p

CONCLUSIONS: The BRISK Scale is a promising new brief observational measure of clinical risk communication competence.



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