Presenting Author:

Bruce Henschen

Principal Investigator:

Dan Evans, M.D.

Department:

Medicine

Keywords:

Education Centered Medical Home, Patient Communication, Medical Education, Primary Care, Patient Centered Medical Home

Location:

Third Floor, Feinberg Pavilion, Northwestern Memorial Hospital

E19 - Education

Patient-student communication in the ECMH clinical clerkship: A pilot study

Effective patient communication is a critical component of both medical practice and medical education. Medical curricula typically include formal training in interpersonal skills and patient-physician communication, but real-time data on medical student communication skills is lacking. The Education-Centered Medical Home is a longitudinal, team-based outpatient clerkship that embeds pairs of medical students in authentic primary care settings. By involving students in direct patient encounters, this clerkship provides opportunities to assess patients’ perceptions of medical student communication. The Communication Assessment Tool (CAT) is a survey instrument that measures patient perceptions of healthcare workers’ communication skills; it has previously been administered to physicians and resident trainees. The questionnaire consists of 15 items on a 5-point Likert-style scale; results are dichotomized by percent “5” or “excellent” responses. We administered the CAT to patients attending ECMH clinic afternoons about the communication with the students they encountered. We also surveyed the student pair who interacted with that patient during clinic using a modified version of the CAT questionnaire. We surveyed 18 student-patient pairs in total. Patients’ average score was 56.8% “excellent” responses; highest ratings were for “paid attention to me,” “Let me talk without interruptions,” “Gave me as much information as I wanted,” and “Spent the right amount of time with me” (61% “excellent” responses), while lowest ratings were for “Greeted me in a way that made me feel comfortable” (50%). Although these scores are lower than prior patient surveys of medical practitioners, they are comparable to the scores in prior studies assessing Emergency Medicine and Family Medicine residents. When assessing their own communication effectiveness, students reported much lower scores overall (26.6% “excellent” responses), regardless of class year. They scored themselves highest on “Paid attention to the patient” (43%) and “Showed care and concern” (40%), and lowest on “Understood the patient’s health concerns” and “Checked to make sure the patient understood everything” (6.6% each). M3 and M4 students’ self-reports correlated slightly better with patients’ scores. Overall, this pilot study demonstrates preliminary evidence that student communication effectiveness in the ECMH is similar to that of residents in other clinical settings. Patient evaluations of medical student communication are a novel way to assess student performance. The discrepancy between patient-reported scores on the CAT and student self-assessment of their own communication skills should be explored further; future directions also include surveying patients from a variety of settings and probing reasons for the discrepancy in scores between patients and students.