Use of a Standardized Communication Card Facilitated Patient-as-Teacher Training on Communication Skills and Improved Patient Care in the Neurology Clerkship
Carmen Priego 1, Punthitra Arpornsuksant2, Rajaa Alhamd2, Monica Lemmon3, Roy Strowd 4, Charlene Gamaldo2, Doris Leung5, Rachel Marie Salas2
1University of Cordoba School of Medicine, 2Johns Hopkins Medicine, 3Duke University, 4Wake Forest School of Medicine, 5Kennedy Krieger Institute
Objective:
To evaluate the impact of a Patient-as-Teacher communication card on teaching students communication skills and improving patient care.
Background:
Enhanced communication has been recognized as an effective strategy to improve patient safety and care quality. While some communication skills training can be taught, learning from patient encounters is critical. The Patient-as-Teacher Communication Card was introduced into the neurology clerkship. Students were required to meet with a patient after rounds and use the card to ask a series of questions prompting patients to describe their perspective on the illness, encourage students to give updates back to the team, and advocate for patients.
Design/Methods:
This was a descriptive qualitative study. Students taking the neurology clerkship between 2017-2022 were asked to select at least 1 patient encounter and utilize the Communication Card. The card collected quantitative data and two open-ended questions: (Q1) how has the card changed how you follow-up with patients after rounds, (Q2) how this follow-up impacted patient care. Data was analyzed using NVivo with two coders in consensus.
Results:
A total of 460 students completed the card (MS2 14.6%, MS3 56.5%, MS4 28.9%). Most (77%) learned new information from the patient to report back to the clinical team. Themes identified for Q1 on the impact of the card on student communication skills, students reported the card helped them guide challenging conversations, build rapport, ensure patient understanding, and spend more time with patients. Themes identified for Q2 on the impact on patient care included that patients were more comfortable with their diagnosis and plan, their concerns were addressed, they felt more heard and trusting of the medical team and had a better treatment adherence.
Conclusions:
The Patient-as-Teacher Communication Card is an effective tool for medical students to learn to navigate challenging conversations and positively influence patient care.