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(Fassaert + 2017)

Active Listening Observation Scale (ALOS-global)

Active listening in medical consultations: Development of the Active Listening Observation Scale (ALOS-global)
  • Thijs Fassaert, 
  • Sandra van DulmenC 
  •  Sandra van Dulmen
  • François Schellevis, 
  • Jozien Bensing




Active listening is a prerequisite for a successful healthcare encounter, bearing potential therapeutic value especially in clinical situations that require no specific medical intervention. Although generally acknowledged as such, active listening has not been studied in depth. This paper describes the development of the Active Listening Observation Scale (ALOS-global), an observation instrument measuring active listening and its validation in a sample of general practice consultations for minor ailments.


Five hundred and twenty-four videotaped general practice consultations involving minor ailments were observed with the ALOS-global. Hypotheses were tested to determine validity, incorporating patients’ perception of GPs’ affective performance, GPs’ verbal attention, patients’ self-reported anxiety level and gender differences.


The final 7-item ALOS-global had acceptable inter- and intra-observer agreement. Factor analysis revealed one homogeneous dimension. The scalescore was positively related to verbal attention measured by RIAS, to patients’ perception of GPs’ performance and to their pre-visit anxiety level. Female GPs received higher active listening scores.


The results of this study are promising concerning the psychometric properties of the ALOS-global. More research is needed to confirm these preliminary findings.