Patients' views on physicians' communication skills in telemedicine: Validation of Communication Assessment Tool among Bangladeshi sample.

Background: Technological advancement has added new dimensions to the communication between physicians and their patients in healthcare settings worldwide. This study aimed to measure patients' views about physicians' interpersonal communication during telemedicine consultations by cultural adaptation and validation of the communication assessment tool (CAT) in Bangladesh.

Methods: A cross-sectional phone survey was conducted among 400 patients who received healthcare services from a telemedicine centre in Bangladesh. Both exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed to test the dimensionality of the CAT-Bangla scale. The goodness of fit of the CFA was assessed using the comparative fit index (CFI), Tucker-Lewis index (TLI), Chi-square values, root-mean-square error of approximation (RMSEA) and standardized root mean squared residual (SRMR). The internal consistency reliability of the CAT-Bangla scale was assessed using Cronbach's alpha.

Results: Factor analysis findings suggest that the CAT-Bangla scale is unidimensional with good internal consistency (Cronbach's α = 0.876). The individual item analysis findings suggest that most of the patients felt that the physicians treated them with respect (81% rated 'excellent') and allowed them to talk without interruption (73.5% rated 'excellent'). Overall, the level of satisfaction among patients regarding physicians' communication skills was high with a mean score of 4.36 (SD = 0.30) across all the 14 items. However, the patients were not satisfied with the amount of time that physicians spent with them as none of them reported 'excellent' in that domain.

Conclusion: The CAT-Bangla scale is feasible, valid, and internally consistent for measuring physicians' communication skills in the telemedicine environment. This study can contribute to policymakers regarding the integration of learning communication skills of future physicians to competently deliver healthcare in the telemedicine environment. It would also help to understand various aspects of doctor-patient communication in a telemedicine context.