Keywords: training, family medicine, clinical communication, physical therapy, rehabilitation medicine, patient compliance, empathy, validation, survey, questionnaire.

Background:

Effective communication in healthcare enhances patient motivation, engagement, and compliance. In physical and rehabilitation medicine, structured and empathetic interactions improve outcomes. However, Ukraine lacks easy-to-use mnemonic tools tailored to rehabilitation-specific communication. To address this gap, we developed “(KPD)² + ENZiM” — a model combining instructional strategies with elements of patient-centered care. It includes:
K–C: Command & Comment
P–P: Plain Phrases & Paraphrase
D–D: Demonstrate & Direct Touch
ENZiM: Empathy, Non-judgment, Zeal (Engagement), Mimics
The model was created within the research project “The correlation of compliance and quality of life in patients with post-traumatic pain syndrome and communication skills of medical staff”, supported by the ShowUp4Health grant.

Research questions:

How to evaluate the face and content validity of the “(KPD)²+ENZiM” communication model in rehabilitation care.

Method:

The tool was presented as a mnemonic combining six core interaction strategies and four empathy-based elements. Twenty-six healthcare professionals (clinical communication trainers, PM&R physicians, therapists, nurses, and family doctors) rated each element using a 5-point Likert scale. Item Impact Scores (IIS) were calculated. Additionally, 10 experts with over 5 years of experience assessed item relevance, purpose alignment, and clarity, allowing calculation of the Content Validity Ratio (CVR) via Lawshe’s method.

Results:

The results demonstrated high scores for each component in both the Item Impact Score (IIS) and the Content Validity Ratio (CVR), Content Validity Index (CVI). Specifically, IIS scores ranged from 4.77 to 4.92, and CVR values ranged from 0.90 to 1.00, CVI values 0.99, indicating a high level of expert agreement regarding the importance and clarity of the model’s elements. The model received high expert ratings: this reflects strong clarity, relevance, and perceived value across all components.

Conclusions:

The “(KPD)²+ENZiM” demonstrates strong validity and practical relevance in rehabilitation settings. It offers a structured, memorable, and empathetic approach to improving communication, enhancing trust, and promoting patient adherence in clinical practice.

Points for discussion:

How can this model be adapted for non-rehabilitation settings (e.g., primary care, emergency medicine)?

What are the training needs and barriers to integrating this tool in routine practice?

Could the model support better communication with patients from vulnerable or low-literacy populations?