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Orienting multiple interviewers: the use of an interview orientation and standardized interview.

An interviewer orientation protocol and standardized interview can be an effective way of orienting multiple interviews to qualitative research. A standardized interview involves an actor taught to portray a research participant consistently in several interview encounters. In this article, the authors describe the interview protocol, and the development and application of a standardized interview. The benefits of using a standardized interview as a formative method to orient multiple interviewers include assessing the interviewers' integration of the interview protocol, the nonverbal and verbal presentation of the interview process between interviewers, and the general flow of the interview from interviewer to interviewer. As more qualitative research is conducted using multiple interviewers, the method of an interview protocol and subsequent standardized interview might be helpful when orienting interviewers to the challenges and promises of conducting research using a critical framework.

Humans↗

Evaluation of an interviewer as a function of interviewer gaze, reinforcement of subject gaze, and interviewer attractiveness.

Male subjects were interviewed by female interviewers who gazed constantly, intermittently, or not at all. Experimental subjects were reinforced with green light feedback whenever they gazed at the interviewers and were punished with red light feedback when they averted gaze for more than 6 seconds. Control subjects received noncontingent green and red light feedback. Although gaze of experimental subjects toward the interviewers was increased significantly, their attitudes toward the interviewers remained the same. This was probably because the subjects did not discriminate that their gazing behavior had changed. Subjects gave the most unfavorable reactions to the nongazing interviewers, rating them as least attractive, giving them the shortest answers, and sitting farthest from them during the debriefing session. Subjects did not discriminate between high and low attractive interviewers, except that the latter were rated disproportionately low on attentiveness if they did not gaze. Interviewers with high rates of talking were preferred over interviewers with low rates of talking. It was concluded that interpersonal attraction is related to gaze and physical attractiveness through a number of mediating variables which will have to be isolated more specifically in future research.

Adolescent↗

Veterinary school admission interviews, part 3: strategies for increasing interview validity.

The veterinary school admission interview is a widely used selection tool, yet concerns persist about its reliability, validity, and cost. Relative to medicine, optometry, and dentistry schools, veterinary schools have been more likely to conduct panel interviews and to fix the interview's weight in selection decisions, strategies that increase interview validity. This article provides strategies for further increasing the veterinary school interview's validity. Interview reliability and validity studies point to key strategies the veterinary school admissions committee can implement before the interview: (1) establishing the interview's purpose(s); (2) conducting a "job" analysis to identify desirable candidate skills, knowledge, and attributes; (3) developing a structured and panel interview where interviewers, if possible, are blind to other admission data; (4) training interviewers; (5) setting a reasonable interview schedule; and (6) determining methods for analyzing applicant data. During the interview, interviewers should proceed through a structured series of steps: (1) open the interview with a specified agenda; (2) probe for information using structured questions and anchored rating scales; (3) close the interview to allow for candidate questions; and (4) evaluate the interview data. After the interview, the admissions committee should (1) analyze the interview data within and across interviewers and (2) analyze the data across all selection tools in order to assign relative weights to the selection tools.

Education, Veterinary↗

The effects of interviewer gender and child gender on the informativeness of alleged child sexual abuse victims in forensic interviews.

Most students of forensic interviews have focused on the interrogatory techniques used to elicit information from alleged child abuse victims. We asked how the gender of the interviewer and the gender of the child affected this process. Forensic investigators in three countries used either the NICHD structured interview protocol or local standard interview practices to interview 672 alleged victims who ranged in age from 4 to 14 years. Analyses of the interviews showed significant effects of gender on both the interviewers' behavior and the amount of information provided by children. Female interviewers asked boys more invitations, as well as absolutely and proportionally more suggestive questions, than they did girls, whereas male interviewers interviewed boys and girls similarly. Children's responses varied depending on their gender and age, the gender of the interviewer, and the type of question asked. Girls of all ages provided more information in response to directive questions posed by female rather than male interviewers whereas boys did not respond differently to male and female interviewers. The oldest girls provided more information in response to option-posing questions posed by male interviewers. More information was provided by the younger children in response to suggestive prompts from interviewers of the opposite gender. The gender-of-interviewer effects were attenuated in protocol-guided interviews.

Adolescent↗

The validity of the interviewer severity ratings in groups of ASI interviewers with varying training.

AIMS: This study evaluated the hypothesis that the subjective interviewer severity rating (ISR) summary indices of the intake Addiction Severity Index (ASI) of less trained interviewers are less valid than those of more highly trained interviewers. DESIGN: Baseline ASIs from three completed studies whose interviewers varied in degree of initial ASI training and subsequent quality assurance monitoring were examined. Associations between baseline ISRs and three other sets of ASI summary indices not based on interviewer ratings-composite scores, clinical indices and evaluation indices-were compared for three groups of interviewers with varying amounts of training. The assumption underlying these analyses was that more reliable ISRs, found in more trained interviewers, would be more highly associated with the other more objective indices. SETTING: Methadone maintenance patients in the Philadelphia and New York City areas. PARTICIPANTS: Thirty-five interviewers with the most intense training who administered 295 interviews; 10 interviewers with an intermediate level of training who administered 763 interviews; and eight identified (and other unidentified) least trained interviewers who administered a total of 276 interviews. Measurements and methods. Four sets of summary indices from the above ASIs. Both bivariate and multivariate analyses were performed. FINDINGS: The study found that the validity of the validity of ISRs was greater in more trained interviewers. CONCLUSIONS: Greater training and subsequent monitoring of ASI interviewers generally appears to be associated with increased ISR validity.

Adult↗

Medical student selection: choice of a semi-structured panel interview or an unstructured one-on-one interview.

Reliability has been shown to be higher in structured medical admissions interviews as compared to unstructured interviews. This study reports the comparison of a proposed semi-structured panel interview with a current individual unstructured medical admissions interview. Inter-rater reliability coefficients were calculated, and correlations were estimated between panel, individual and academic scores. Admission status in 2003 was related to these scores by means of logistic regression. Both individual and panel interviews were significantly correlated with admissions status. The inter rater reliability coefficient (from individual interviews) was 0.12 whereas the interpanel reliability coefficient was 0.52. Panel interview: good across panel and within panel consistency of scoring. No effect of who asked the questions, question order, or interview duration on scoring. No correlation between panel interview scores and academic variables (MCAT, GPA). We found good inter-panel reliability, a high consistency within and between interview panels, and uniformly positive questionnaire responses. The panel interview measures something different from academic variables. These data, in conjunction with a strong sense from the medical and psychological literature supporting the reliability and validity of a semi-structured panel interview, support our decision to replace our individual interview with the panel interview.

Adult↗

Semistructured child sexual abuse interviews: interview and child characteristics related to credibility of disclosure.

This study provided the first empirical description of child and interviewer behaviors occurring within semistructured assessment interviews with children suspected of being victims of sexual abuse. Specifically, relationships between child and interviewer characteristics and interview credibility were examined. Using the Child Abuse Interview Interaction Coding System (CAIICS, Wood, 1990), 55 videotaped interviews of high-risk sex abuse cases seen at a multidisciplinary assessment center were behaviorally coded. Support was found for the interrater reliability and criterion related validity of the CAIICS was found. Results also revealed that children were initially rated as relaxed and displayed few emotional behaviors. Thus, the assumption that a credible disclosure of abuse must necessarily include the display of emotion by the child was not supported. Second, several behavioral differences between preschool and school-aged children were identified: however, no meaningful gender differences were found. Third, supporting evidence was found for both age and gender effects in judgments of interview credibility, with girls and school-aged children judged as more credible. Fourth, while the interviewer did engage in so called leading behaviors, these behaviors were not found to be related to rating of interview credibility. However, interviewer behaviors may have affected interview credibility through an intervening variable. Finally, implications, for further use of the CAIICS for examining interviewer-child interactions, evaluating standards of practice, and assisting with interviewer training are discussed.

Child↗

Reports of smoking in a national survey: data from screening and detailed interviews, and from self- and interviewer-administered questions.

PURPOSE: This study compares responses to questions about smoking in a brief screening interview with those from a subsequent, more detailed interview; it also compares responses to self-administered questions and questions administered by interviewers. The data are from the 1994 National Household Survey on Drug Abuse (NHSDA). METHODS: About 22000 respondents completed the main questionnaire of the 1994 NHSDA. Earlier, a member of each sample household had been asked to provide screening information, including smoking status, for each person in the household. Then, one or more persons in the household were interviewed about their own smoking and drug use; for some respondents, the questions about smoking were self-administered and for others they were administered by an interviewer. We examined discrepancies between reports about smoking from the screening data and main interview data; we also compared the results across the two versions of the main interview smoking questions (self and interviewer-administered). RESULTS: The screening data produced lower estimated rates of smoking than did the main interview data, particularly when proxies provided the screening data. In the main interviews, self-administered questions produced higher estimates of the prevalence of smoking than interviewer-administered questions, but only for adolescents. CONCLUSIONS: Proxies can provide some information about smoking, although the data are likely to be biased for younger age groups and for infrequent smokers. For adolescents, self-administration appears to elicit more candid reports about smoking than interviewer administration. In addition, multiple items may help to capture smoking reports by persons who are reluctant to admit they have smoked recently or whose status as smokers is unclear.

Adolescent↗

Do interviewers' health beliefs and habits modify responses to sensitive questions? A study using data Collected from pregnant women by means of computer-assisted telephone interviews.

If interviewers' personal habits or attitudes influence respondents' answers to given questions, this may lead to bias, which should be taken into consideration when analyzing data. The authors examined a potential interviewer effect in a study of pregnant women in which exposure data were obtained through computer-assisted telephone interviews. The authors compared interviewer characteristics for 34 interviewers with the responses they obtained in 12,910 interviews carried out for the Danish National Birth Cohort Study. Response data on smoking and alcohol consumption in the first trimester of pregnancy were collected during the time period October 1, 1997-February 1, 1999. Overall, the authors found little evidence to suggest that interviewers' personal habits or attitudes toward smoking and alcohol consumption during pregnancy had consequences for the responses they obtained; neither did the interviewers' education, age, or parity correlate with the answers they obtained. In these data gathered through computer-assisted telephone interviews, interviewer effects arising from variations in interviewers' health beliefs and personal habits were found to be negligible. Thorough training of the interviewers and continuous supervision may have contributed to this finding.

Adult↗

Time-tradeoff values and standard-gamble utilities assessed during telephone interviews versus face-to-face interviews.

The purpose of this study was to compare time-tradeoff values and standard-gamble utilities obtained during telephone interviews with those obtained through face-to-face interviews. Sixty-five patients with peripheral arterial occlusive disease completed both interviews. One week prior to the telephone interview, the patients received by mail a questionnaire in which the value and utility measures were presented in writing. The face-to-face interviews used the same questions, but the interviewer used visual aids. The mean time-tradeoff values were 0.84 (SD 0.20) vs 0.86 (SD 0.17) for the telephone and face-to-face interviews, respectively (p = 0.31). The mean standard-gamble utilities were 0.93 (SD 0.16) vs 0.92 (SD 0.17) for the telephone and face-to-face interviews, respectively (p = 0.26). In conclusion, telephone interviews yield similar time-tradeoff values and standard-gamble utilities compared with face-to-face interviews, suggesting that telephone interviews can replace face-to-face interviews.

Adult↗

Comparison of interviewed and non-interviewed non-Hodgkin's lymphoma (NHL) patients in the San Francisco Bay Area.

PURPOSE: To determine whether interviewed non-Hodgkin's lymphoma (NHL) patients differed from non-interviewed NHL patients and to revise the population-based risk estimate for NHL associated with HIV infection in homosexual men in the San Francisco Bay Area. Differences between study participants and non-participants are a concern in epidemiologic studies. Recruitment techniques can be modified when nonparticipation is a result of subject refusal. However, the solutions for nonparticipation due to death are less clear, especially when rapid case ascertainment (RCA) is used to identify newly diagnosed patients. METHODS: A large population-based case-control study was conducted in the San Francisco Bay Area between 1988 and 1995 to investigate risk factors for NHL. Nearly 1600 patients were interviewed and included in this study. A total of 1047 NHL patients were not interviewed because they had died prior to contact (602 patients) or we had received their RCA information after the study had ended (445 patients). We compared available demographic, clinical, and histologic profiles of the interviewed and non-interviewed NHL patients. RESULTS: Compared with the interviewed group, the non-interviewed group was younger, had more single HIV-infected homosexual men and a higher incidence of high-grade and "not-otherwise-specified" lymphoma. When categorized by sex and sexual preference, median age at diagnosis of NHL was the same for the interviewed and non-interviewed homosexual men. Combining interviewed and non-interviewed patients, the estimated risk for NHL associated with HIV infection in homosexual men [odds ratio (OR) = 50] is substantially higher than we had estimated in our earlier publications (OR = 20). CONCLUSIONS: High-grade lymphomas associated with poor survival in homosexual men are likely to be under-represented in case-control studies of NHL.

Adult↗

A cost efficiency comparison between the multiple mini-interview and traditional admissions interviews.

A major expense for most professional training programs, both financially and in terms of human resources, is the interview process used to make admissions decisions. Still, most programs view this as a necessary cost given that the personal interview provides an opportunity to recruit potential candidates, showing them what the program has to offer, and to try and gather more information about the candidates to ensure that those selected live up to the espoused values of the institution. We now have five years worth of experience with a Multiple Mini-Interview (MMI) process that, unlike traditional panel interviews, uses the OSCE model to have candidates interact with a larger number of interviewers. We have found that the MMI is more reliable and has better predictive power than our traditional panel interviews. Still, the extent to which any measurement is valuable depends also on the feasibility of use. In this paper we report on an exploration of the cost effectiveness of the MMI as compared to standard panel-based interviews by considering the generation of interview material, human resource (i.e., interviewer and support staff) use, infrastructure requirements, and other miscellaneous expenses. Our conclusion is that the MMI requires greater preparatory efforts and a larger number of rooms to carry out the interviews relative to panel-based interviews, but that these cost disadvantages are offset by the MMI requiring fewer person-hours of effort. The absolute costs will vary dependent on institution, but the framework presented in this paper will hopefully provide greater guidance regarding logistical requirements and anticipated budget.

Humans↗

[An instrument for evaluating th medical interview in general practice: VR-MICS/D (Verona-Medical Interview Classification System/Doctor)].

OBJECTIVE: To assess the reliability of the VR-MICS/D (Verona-Medical Interview Classification System/Doctor) and to identify the verbal behaviour by general practitioners in interviews conducted with primary care attenders with medical complaints and emotional distress. SETTING: Two general practices in South-Verona. SAMPLE: 100 primary care patients attending for a new illness episode with a GHQ-12 score > or = 3. The five participating GPs contributed each with 20 audiotaped interviews of 10 patients judged by GP as emotionally distressed and of 10 judged without emotional distress. MAIN OUTCOME MEASURES: The VR-MICS/D classifies GPs' verbal behaviour during the medical interview into 16 categories in terms of form (question or statement) and content and allows to assess their interview skills. PROCEDURE: Two raters classified 30 interviews (15 with patients judged by their GP as emotionally distressed and 15 with patients judged without emotional distress). Having established satisfactory reliability, the overall verbal performance, based on 100 interviews, was assessed and GPs' verbal behaviours with patients judged as emotionally distressed was compared with that adopted with patients judged without emotional distress. RESULTS: The reliability was satisfactory (Kappa 0.93). Percentage agreements for categories varied between 78.2% and 96.4%. The most frequent verbal behaviours were closed ended questions and information giving (58% of a total of 5522 classified verbal units). Interviews with patients judged as emotional distressed contained a greater number of psychological and psychosocial contents, facilitating comments and clarifications. These differences, however, were small, despite their statistical significance. CONCLUSIONS: The VR-MICS/D is a reliable measure for describing GPs' verbal behaviour during the interview with emotional distressed patients. The interview style of the GPs in this study was similar to that reported in the literature for GPs without formal training in communication skills and was characterised by a prevalently doctor-centred approach. This approach, particularly with emotional distressed patients, has severe limitations and underlines the necessity of the introduction of communication skills training.

Communication↗

Renard diagnostic interview. Its reliability and procedural validity with physicians and lay interviewers.

A psychiatric diagnostic interview that can be reliably and validly administered by nonpsychiatric physicians and lay interviewers has both research and clinical applications. We examined the interrater reliability and procedural validity of the Renard Diagnostic Interview (RDI), an instrument designed for these purposes. Randomly selected psychiatric inpatients were interviewed once by a psychiatrist using our standard departmental research interview and were then given RDIs by two psychiatrists, two lay interviewers, or one of each. The reliability of the RDI is estimated by examining diagnostic concordance for the two RDI interviews. Procedural validity is estimated by examining diagnostic concordance between the RDI and the traditional departmental interview. Both reliability and procedural validity were found to be high, and the study demonstrates that lay interviewers using the RDI after a brief period of training can obtain accurate diagnostic information.

Humans↗

Children's type A interview: interrater, test-retest reliability, and interviewer effect.

The Miami Structured Interview--1 was developed to assess Type A behavior in preadolescents and adolescents in the United States and Greece. This report describes the interrater and test-retest reliability of the Miami Structured Interview--1, and the effect of different interviewers on the assessment process. Interrater agreements on the A vs not A scale were 73% for Greek American (k = 0.49, p less than 0.01, n = 88), 80% for Mixed American (k = 0.61, p less than 0.01, n = 69), and 88% for Native Greek interviews (k = 0.76, p less than 0.01, n = 65). Exact agreements on a five-point scale were 48% (weighted k = 0.73, p less than 0.01), 42% (weighted k = 0.70, p less than 0.01), and 48% (weighted k = 0.80, p less than 0.01), respectively. Although levels of agreement were all greater than chance, rater bias was observed. Test-retest administrations within 10 min showed 91% agreement (k = 0.82, p less than 0.01) on the A vs not A scale. Analyses suggest interviewers can affect the assessment of Type A behavior. These findings indicate the Miami Structured Interview--1 can (1) reach acceptable levels of interrater reliability, (2) is susceptible to rater bias, (3) has sufficient test-retest reliability for use in longitudinal studies, and (4) must be presented in a standardized way before ratings from interviews conducted by different interviewers can be combined or compared. The strengths and limitations of the Miami Structured Interview-1 are discussed.

Adolescent↗

Interviewing for sexual abuse: reliability and effect of interviewer gender.

An interview to detect histories of sexual abuse was administered to consecutive attenders at a gynecology clinic on two occasions, on one occasion by a male interviewer and on the other by a female interviewer. Fifty-six subjects were assessed, and at least partial agreement was found in 70% between the two interviews. Approximately one-third of incidents were reported at only one of the interviews, with gender of interviewer making little apparent difference to this. Contrary to expectation, subjects appeared more forthcoming at the first interview. Reasons for this are discussed. Interviews for sexual abuse must be carried out in an appropriate context, and simple routine screening questions may not be appropriate. Selection of interviewers on the basis of gender alone may not be helpful.

Adolescent↗

The predictive utility of behavior-based interviewing compared with traditional interviewing in the selection of radiology residents.

RATIONALE AND OBJECTIVES: This study compares the predictive use of measures based on traditional faculty and resident interviews of residency applicants with measures obtained through behavior-based interviewing. A special emphasis was placed on predicting residents' noncognitive abilities. METHODS: One hundred fifty-one resident applicants, over a 3-year period, were interviewed using standard interviews by faculty and residents. These residents also were interviewed with an experimental behavior-based accomplishment interview. Four years later, during their diagnostic radiology residency, evaluations of performance were gathered on these applicants from their residency director. RESULTS: Results indicated that scores based on responses given during the accomplishment interviews added considerable predictive utility to the low prediction demonstrated by traditional interviews. CONCLUSIONS: These findings imply that improving unstructured faculty and resident interviews to obtain, in a more rigorous manner, desired information about noncognitive abilities may be a key to successful resident selection.

Behavior↗

Interview expectations and experiences of optometry applicants and interviewers.

This 1996 study examined the admission interview employed at the University of Waterloo School of Optometry (UWSO). A questionnaire was developed, piloted, and mailed to 157 UWSO applicants and 23 UWSO interviewers. Their expectations of an ideal optometry admission interview were compared with their experiences of the UWSO admission interview. The response rate was 71.7% (n = 129; 109 applicants, 20 interviewers). Statistical analysis involved principle component analysis and t-tests (independent and paired). Participants believed the ideal optometry admission interview should gather information, verify information, provide information, and select candidates by appraising their 'people skills,' 'professional skills,' and 'attitude orientation.' Although the participants' expectations of the ideal interview resembled the mission statement of the UWSO interview, the expectations, particularly among applicants, significantly deviated from their experiences of the UWSO interview.

Adult↗