PANSS Rater Training Using Internet and Videoconference

Kobak, Kenneth

Abstract

The long term objective of the project is to improve inter-rater reliability in schizophrenia assessment by developing training tools using new technologies that enable the widespread dissemination of a high quality, standardized rater training on the PANSS. Such a program will have great utility in multicenter clinical trials, where raters are often at diverse sites, and making inter-rater reliability across sites difficult to achieve. Training conducted at start-up meetings have proved ineffective in this regard. The specific objectives during phase I project are to 1) develop a prototype of a interactive training tutorial on the administration and scoring of the PANSS, delivered on both CD-ROM and a secure Internet website; 2) develop pre- and post-tests to evaluate the efficacy of the tutorial in improving trainees' conceptual knowledge; 3) evaluate the feasibility of applied, clinical training (i.e., live observation of trainees conducting PANSS interviews) through the use of videoconference technology; 4) evaluate the feasibility and user satisfaction of both components in order to improve final design for phase II. The training program will be pilot testing on a group of 12 raters. Following completion of the CD-ROM tutorial, each trainee will interview {via videoconference) two standardized patients who are at a remote location with the trainer, who will provide live observation and feedback in real time. Pre- and post-test measures of both didactic knowledge and clinical skills will be obtained. Technical issues, such as problems with the maintenance or quality of the video link, or difficulties site staff have in using the equipment, will be evaluated. Training on applied skills is critically important, and is virtually overlooked in current rater training designs. Recent research by our group has shown that poorly conducted interviews had significantly greater placebo response than interviews that were conducted well. Our previous studies on the use of this training paradigm (CD-ROM plus live applied training) has been shown to be successful in the areas of both depression and autism assessment. ? ?