Use of a standardized patient satisfaction questionnaire to assess the quality of care provided by ophthalmology residents

Raja Jagadeesan, Dev N Kalyan, Paul Lee, Sandra Stinnett, Pratap Challa
Ophthalmology 2008, 115 (4): 738-743.e3

PURPOSE: To develop and use a standardized patient satisfaction questionnaire (PSQ) to address two study questions: (1) What is the overall level of satisfaction with resident care? (2) Can the study questionnaire be used to detect differences in the level of satisfaction patients have with care delivered by individual residents?

DESIGN: Cross-sectional study comprising a survey administration to an ophthalmology resident clinic population of an existing PSQ, namely, the Duke Clinics Patient Satisfaction Questionnaire-adapted for use in ophthalmology ambulatory clinic settings. The questionnaire subscales roughly correlate to 3 Accreditation Council for Graduate Medical Education (ACGME) general competencies: interpersonal and communication skills, professionalism, and technical quality of care.

PARTICIPANTS: The survey was completed by 167 qualified patients of the Durham, North Carolina Veterans Administration Hospital Eye Clinic, a clinic staffed by residents of Duke Eye Center.

METHODS: Patients were administered a standardized PSQ assessing 4 areas of care: interpersonal manner, communication, technical quality, and professionalism. Overall levels of satisfaction with care were assessed; bivariate analyses were used to assess scores by resident. Primary outcomes were measured as levels of satisfaction on a 5-point scale (1 = lowest satisfaction, 5 = greatest). Outcomes were calculated separately for the 4 satisfaction subscales.

MAIN OUTCOME MEASURE: Patient satisfaction using a standardized PSQ.

RESULTS: Mean scores were 4.46 for interpersonal manner, 4.46 for communication, 4.27 for technical quality, and 4.63 for professionalism. Analysis by resident yielded statistically significant (P<0.05) differences in scores between residents on the interpersonal manner (P = 0.02) and communication (P = 0.03) subscales.

CONCLUSIONS: The ACGME has established 6 areas of patient care "general competencies" in which all residency programs are mandated to train and evaluate residents, creating a need for the development of new measurement tools. Using a modified version of an established PSQ to measure 3 general competencies, we found that patients were generally satisfied with resident care, and that differences in patient satisfaction with the interpersonal and communication skills of individual residents can be identified using our PSQ. The PSQ described here may be a useful assessment tool for ACGME-mandated resident core competency in interpersonal and communication skills.

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