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Development of a measure of clinicians’ self-efficacy for medical communication (SEMC)
  1. David B. Feldman1,
  2. Mark A. O'Rourke2,
  3. Benjamin W. Corn3,
  4. Matthew F. Hudson2,
  5. Naimik Patel2,
  6. Rajiv Agarwal4,
  7. Valerie L. Fraser5,
  8. Heidi Deininger6,
  9. Lauren A. Fowler7,
  10. Marie A. Bakitas8,
  11. Robert A. Krouse9 and
  12. Ishwaria M. Subbiah10
  1. 1Santa Clara University, Santa Clara, California, USA
  2. 2Prisma Health Upstate Cancer Institute, Greenville, South Carolina, USA
  3. 3Shaare Zedek Medical Center, Jerusalem, Israel
  4. 4Vanderbilt University Medical Center, Nashville, Tennessee, USA
  5. 5SWOG Cancer Research Network, San Antonio, Texas, USA
  6. 6University of Michigan Rogel Cancer Center, Ann Arbor, Michigan, USA
  7. 7University of South Carolina School of Medicine Greenville, Greenville, South Carolina, USA
  8. 8University of Alabama at Birmingham, Birmingham, Alabama, USA
  9. 9University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
  10. 10University of Texas MD Anderson Cancer Center, Houston, Texas, USA
  1. Correspondence to Dr David B. Feldman, Department of Counseling Psychology, Santa Clara University, Santa Clara, CA 95053, USA; dbfeldman{at}


Objectives Studies of clinician–patient communication have used varied, ad hoc measures for communication efficacy. We developed and validated the Self-Efficacy for Medical Communication (SEMC) scale as a standard, quantitative measure of clinician-reported skills in communicating difficult news.

Methods Using evidence-based scale development guidelines, we created two 16-item forms of the SEMC, one assessing communication with patients and one assessing communication with families. Clinicians providing oncological care in four organisations were invited to participate and provided consent. Participant demographics, responses to the SEMC items and responses to convergent and discriminant measures (those expected to relate strongly and weakly to the SEMC) were collected online. We performed analyses to determine the convergent and discriminant validity of the SEMC as well as its reliability and factor structure.

Results Overall, 221 oncology clinicians (including physicians, residents, fellows, medical students, nurses, nurse practitioners and physician assistants) participated. The patient and family forms both demonstrated high internal consistency reliability (alpha=0.94 and 0.96, respectively) and were strongly correlated with one another (r=0.95, p<0.001). Exploratory factor analysis demonstrated that the SEMC measures a unitary construct (eigenvalue=9.0), and its higher mean correlation with convergent (r=0.46) than discriminant (r=0.22) measures further supported its validity.

Conclusions Our findings support the SEMC’s validity and reliability as a measure of clinician-rated communication skills regarding conducting difficult conversations with patients and families. It provides a useful standard tool for future research in oncology provider–patient serious illness communication.

  • Communication
  • Education and training

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  • Presented at This study was presented as a poster (Abstract #12124) at the 2021 Annual Meeting of the American Society of Clinical Oncology (ASCO).

  • Contributors All authors contributed to the conception of the study, study design, collection of data, and writing and editing of the manuscript. DBF conducted analysis of the data, approved the final version to be published, and is responsible for the overall content as guarantor. BC, HD, LF, MO'R, RA and VF helped with participant recruitment.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests RA is supported by NIH/NCI (K12CA090625). IMS is supported by the American Cancer Society (ACS) Clinician Scientist Development Grant and the Andrew Sabin Family Foundation.

  • Provenance and peer review Not commissioned; externally peer reviewed.