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Scores for several other variables were closely grouped: Listened without Interruption (5-Likert scale, mean 4.44 and 4.19), Maintained Appropriate Distance (dichotomous, yes?=?96.3% and 100%), and Asked Relevant Questions (dichotomous, yes?=?92.6% and 88.9%). Intraclass correlation coefficients analysis showed that SP and second rater team scores had moderate to substantial agreement (Table?2). In this study, reliability analysis for the composite variables included Establishing Rapport 0.755 (P value?[http://www.selleckchem.com/products/z-vad-fmk.html Selleckchem ZVADFMK] (P value 0.065); and Overall Satisfaction 0.445 (P value 0.090). In depth investigation of individual SP scores compared to the second rater team scores, checklist item by checklist item, illuminated some issues with observations between SPs 3 and 5 and the second rater team (Table?2). Specifically, there was negative covariance with the composite variable Non-Verbal Communication and for Overall Satisfaction, a violation of reliability modeling. However, the generally high correlation (��?75%) between all of the other [http://en.wikipedia.org/wiki/RhoC RhoC] SPs and the second rater team raised the cumulative ICCs for the collective comparison of SP scores to the second rater team. Thus, the group cumulatively generated moderate to substantial agreement. There was general agreement in the comments made by SPs and second raters with a few interesting exceptions. In one of the SP�Cnurse interactions, the individual SP scored the nurse with a 3 (neutral) but commented that the nurse seemed uncomfortable and made her ��a little nervous.�� The SP further commented that the nurse did not give her the opportunity to talk about her family problems. For the same interaction, second raters also scored the [http://www.selleckchem.com/products/ly2157299.html Galunisertib cost] nurse with a 3 but simply noted that the nurse minimized the impact of the death of patient's father. This illustration showed the different vantage points of the rater types, or the different contexts of the raters. In another instance, the SP scored the nurse's overall communication as 4 (satisfactory) while the second rater team scored the nurse as a 1 (extremely dissatisfied). Their respective comments further illustrate differences in the point of view by rater type. The SP commented that, even though the nurse did not ask more about her situation, the nurse was ��nice and made me feel relaxed.�� Second raters noted that the nurse continually interrupted the patient when she was trying to answer questions posed to her. In this instance, the second raters were very focused on task completion whereas the SP responded to empathy and caring conveyed by the nurse but not specifically measured by the checklist instrument.