Family Practice Residents’ Use of Clear Communication Skills Susan A. Martin, PsyD Gale Kittle, RN, MPH Emily Zaragoza-Lao, MD Department of Family Medicine, St. Joseph’s Hospital & Medical Center, Phoenix, Arizona

Introduction As part of residency training, physician/patient encounters are routinely reviewed for teaching purposes, including ACGME competencies in interpersonal and communications skills In 2008, we established a baseline of resident’s skills in clear communication We proposed that residents interpersonal and communication skills improved based on our implemented curriculum

Results of 2008 study All residents (regardless of year) emphasized key points and encouraged questions 3rd year residents: less likely to assess baseline understanding, explain things in clear language or “use teach-back” (compared to 1st and 2nd year) Results produced the integration of a clear communication/health literacy component to yearly academic curriculum. AMA Health Literacy CME: help your patients understand

Methods 23 FM residents in 3 year training program Written consent from patients/legal guardians and residents IRB approval, 46 video encounters assessed by 3 reviewers (psychologist, RN and physician) 2 reviewers scored each encounter and scores were averaged For interrater reliability, reviewers scored two encounters that were not included in this study, compared and discussed results

8 encounters were 1st year residents, 14 were 2nd years, and 24 were 3rd years For analysis, 1st and 2nd-year residents were combined into one category “Provides useful educational materials” was not included, as this could not be accurately assessed (either video cut off or the resident may have given materials after the patient left the room)

Results

Discussion With the exception of “encourages questions” and “teach-back technique,” all components of clear communications as outlined by our tool improved from 2008 to 2010 Resident time constraints and complexity of patient complaints may play a role in why these dropped

Discussion continued… Video review may be a useful evaluation tool Yearly training for residents in health literacy and clear communication skills Modeling clear communication skills Further studies could evaluate the influence of faculty modeling such behaviors to promote resident clear communication skills

Limitations Small sample size Different populations Variance in reviewers scoring

Questions?

References Kripalani, S., & Weiss, B. D. (2006). Teaching about health literacy and clear communication. Journal of General Internal Medicine, 21, (8). 888-890. Weiss, B. D. (2003). Health literacy: A manual for clinicians. American Medical Association, Chicago. Institute of Medicine. (2004). Health literacy: A prescription to end confusion. National Academies Press, Washington, D. C.