Unhurried Conversations Assessment Tool (UCAT) - Developing and validating

Sep 2, 2026

Unhurried Conversations Assessment Tool (UCAT) is developed to evaluate the unhurriedness of patient-clinician consultations, supporting careful and kind clinical communication. The tool is created by identifying unhurried conversation dimensions and transforming them into assessment items. In the third phase, two independent raters apply UCAT to 100 randomly selected consultations from a larger video dataset, and psychometric analyses assess validity and reliability. Results show strong content and construct validity, high internal consistency across the formative dimensions, and practical clinical use for self-evaluation and training.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages10

Reading Time25 min

AccessFree to download

Developing and validating the Tool (UCAT)

Objective

Methods

Results

Conclusion

Practice implications

Dimensions and definitions

| Developing and validating the Tool (UCAT) | | | Unhurried Conversations Assessment | | | --- | --- | --- | --- | --- | | Dron M. Mandhanaa, b, Cristian Soto Jacome b, c, Dawna I. Ballard d, b, Yohanna Tesfaid, Sarah B. Johnson b, Michael R. Gionfriddoe, Nataly R. Espinoza Suarez b, f, g, Sandra Algarin Pernethb, h, Lillian Sui, Victor M. Montori b, *
a Department of Communication, Villanova University, Villanova, PA, USA
b Knowledge & Evaluation Research (KER) Unit, Mayo Clinic, Rochester, MN, USAc Norwalk Hospital, Department of Internal Medicine, Nuvance Health, Norwalk, CT, USA d Department of Communication Studies, The University of Texas at Austin, Austin, TX, USA
e Division of Pharmaceutical, Administrative, and Social Sciences, School of Pharmacy, Duquesne University, Pittsburgh, PA, USA
f VITAM-Centre for Sustainable Health Research, Integrated University Health and Social Services Center of Capitale-Nationale, Quebec City, QC, Canada g Faculty of Nursing, Laval University, Quebec City, QC, Canada
h Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
i Division of Cardiovascular Intensive Care Medicine, Phoenix Children’s Hospital, Phoenix, AZ, USA | | | | | | A R T I C L E I N F O | | A B S T R A C T | | | | Keywords:
Unhurried conversations Patient-clinician communication Clinical encounters Assessment tool | | Objective: Given the importance of unhurried conversations for providing careful and kind care, we sought to create, test, and validate the Unhurried Conversations Assessment Tool (UCAT) for assessing the unhurriedness of patient-clinician consultations.
Methods: In the first two phases, the unhurried conversation dimensions were identified and transformed into an assessment tool. In the third phase, two independent raters used UCAT to evaluate the unhurriedness of 100 randomly selected consultations from 184 videos recorded for a large research trial. UCAT’s psychometric properties were evaluated using this data.
Results: UCAT demonstrates content validity based on the literature and expert review. EFA and reliability analyses confirm its construct validity and internal consistency. The seven formative dimensions account for 89.93% of the variance in unhurriedness, each displaying excellent internal consistency (α > 0.90). Inter-rater agreement for the overall assessment item was fair (ICC = 0.59), with individual dimension ICCs ranging from 0.26 (poor) to 0.95 (excellent).
Conclusion: UCAT components comprehensively assess the unhurriedness of consultations. The tool exhibits content and construct validity and can be used reliably.
Practice implications: UCAT’s design and psychometric properties make it a practical and efficient tool. Clinicians can use it for self-evaluations and training to foster unhurried conversations. | | | | Dimensions | Conceptual Definitions | Operational Definitions and Examples | | --- | --- | --- | | Dimensions | Conceptual Definitions | Operational Definitions and Examples | | --- | --- | --- | | Off Task Topics | Unhurried conversations involve a discussion of topics unrelated to medical problems or diagnoses that enhance the depth of conversation. | a. Open body language: Open arms; Head nods.
b. Closed body language:
Closed arms; Walking away. References to topics unrelated to medical problems or diagnoses.
Examples:
a. Questions about weekend plans.
b. Discussing hobbies or personal goals. | | Delaying Topics | To support unhurried conversations, participants may delay addressing nonimmediate topics so that more time and attention can be given to pertinent topics. | Delaying or delegating topics to a different time/person. Examples:
a. We’ll discuss that next time.
b. Someone else will be taking it from here. | | Dimensions | ICC (95% CI) | pvalue | Mean (SD) | | | --- | --- | --- | --- | --- | | | | | Rater 1 | Rater 2 | | Grand Item | 0.59 (0.444 to 0.704) | 0.001 | 4.93 (.

FAQs

What does the UCAT tool measure?

UCAT assesses the unhurriedness of patient-clinician consultations by evaluating specific conversational dimensions during clinical encounters.

How was UCAT developed and validated?

Initial phases identified unhurried conversation dimensions and converted them into an assessment tool. Two raters then evaluated 100 randomly selected consultations using UCAT, and psychometric properties were analyzed.

What validation results did UCAT show?

UCAT demonstrated content validity through literature and expert review, and construct validity supported by factor and reliability analyses. Formative dimensions showed excellent internal consistency, while inter-rater agreement varied across items.

Sep 2, 2026

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