Can Verona Coding Definitions of Emotional Sequences (VR-CoDES) be applied to standardized Chinese medical consultations? – A reliability and validity investigation. Issue 8 (August 2019) - Yin, Lanyi
Highlights: Initial good psychometric properties found for the Chinese VR-CoDES. Culture gaps occurred when applying VR-CoDES to simulated Chinese medical consultation. The Chinese VR-CoDES captured most of the emotional expressions presented. The majority of SPs' emotional expressions were cues whilst concerns rarely occurred. Explicit Reduce space Information-advise (ERIa) composed 49.5% of the medic's responses. Abstract: Objective: To investigate the reliability and validity of the Chinese version of VR-CoDES. Methods: The VR-CoDES was translated into Chinese, and a focus group was held to discuss its cultural adaptation. Video consultations between 75 fourth-year medical students and 2 standardized patients (SPs) were coded by two raters with the Chinese VR-CoDES. Inter-rater reliability was tested by using ICC. To obtain validity, the SPs reviewed the video consultations to confirm the cues and concerns. Results: ICC was 0.79. Specificity and sensitivity were 0.99 and 0.96 respectively. The SPs expressed considerably more cues (mean = 7.00) than concerns (mean = 0.32). Half of the responses of medical students were explicit reducing space. Focus group participants raised some cultural considerations, and some interactions were difficult to code due to cultural differences. Conclusion: The Chinese VR-CoDES obtained good reliability and validity. Due to differences in the expression of emotions and other differences such as different medical systems between China and Western countries, the Chinese VR-CoDES needs further cultural adaptation. Practice implication: More consultations in real clinical settings need to be gathered to further support the Chinese VR-CoDES both on validation and cultural adaptation.