Rating Scales for the Assessment of Empathic Communication in Medical Interviews (REM): Scale Development,Reliability, and Validity

Empathy has been shown to affect the quality of care by enhancing the physician–patient relationship and promoting effective communication. In this study, the newly developed Rating Scales for the Assessment of Empathic Communication in Medical Interviews (REM), designed to assess empathy and confrontation in physician–patient interactions, were subjected to preliminary psychometric testing. Particular attention was paid to face validity, reliability, sensitivity, and practicality. A total of 118 volunteers were asked to assess transcribed interactions between physicians and a standardized patient using the REM. In order to assess the convergent validity of the REM, the Motivational Interviewing Treatment Integrity Code (MITI) and the Behavior Change Counseling Index (BECCI) were used. Factor analysis identified two subscales, reflecting empathy and confrontation. Interrater reliability coefficients for items ranged from r = .82 to .97; Cronbach’s alphas for the two subscales were .89 and .88, respectively. The convergent validity was supported by substantial correlations between the REM scores and the MITI scores and by significant correlations between the REM scores and the BECCI score. The REM demonstrated good psychometric properties suggesting the rating scales might be useful in clinical practice, research endeavors, and medical education. Further research is necessary to assess the test-retest reliability as well as the predictive validity of this instrument.