1. 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

2. 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

3. 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

5. 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

6. 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)

7. Results

13. 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

14. 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

15. Limitations Small sample size Different populations
Variance in reviewers scoring

16. Questions?

17. References
Kripalani, S., & Weiss, B. D. (2006). Teaching about health literacy and clear communication. Journal of General Internal Medicine, 21, (8)
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.