Assessment of Emergency Medicine Residents’ Bedside Communication Skills: A Survey of Emergency Department Patients Amanda Keller York College of PA Biology.

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Assessment of Emergency Medicine Residents’ Bedside Communication Skills: A Survey of Emergency Department Patients Amanda Keller York College of PA Biology Department OBJECTIVE: The objective of this study is to assess the bedside communication skills and professionalism of York Hospital Emergency Medicine (EM) residents as perceived by their patients. INTRODUCTION: Physician-patient communication plays a key role in patient satisfaction. Development of communication skills have become a major focus of medical schools, residency programs, and hospitals because when a patient is satisfied, they are more likely to follow post emergency department (ED) instructions, attend follow-up appointments, and take prescribed medications 1,2. Studies have been done to assess physicians’ communications skills by: 1) Evaluation of videotaped physician-patient interactions evaluated by peers 2) Mailed surveys to patients concerning physician-patient interactions, and 3)Patient satisfaction surveys in the Emergency Department, (pediatric patients and their parents) 1. Videotaped evaluations enforced what is known as the Hawthorne effect, when a person changes their behavior when they know that they are being observed. Mailed surveys make it difficult to be sure that the patient was evaluating the correct doctor and that they were able to remember the experience correctly. Patient satisfaction surveys that have been done in the Emergency Department, focused only on pediatric patients and their parents. The York Hospital EM residents are expected to learn appropriate professional behavior and communication at the patients’ bedside as outlined by the Residency Review and Institutional Review Committees (RRC-EM) from the Accreditation Council for Graduate Medial Education (ACGME) 3. Unfortunately there are no specified evaluations given by the RRC-EM. This study will provide the institution a way to evaluate the performance of their ED residents while limiting the Hawthorne effect. METHODS: Inclusion criteria: All patients 18 and older and competent presenting to the Emergency Department for care will be included in this study. Exclusion criteria : patients under age 18, non-English speaking patients, critically ill patients and patients with altered mental status or altered level of consciousness, patients whom are evaluated by medical students, non-emergency medicine residents rotating in the ED and attending physicians. Literature Cited: 1. Magaret ND, Clark TA, Warden CR, Magnusson AR, Hedges JR. (2002) Patient Satisfaction in the Emergency Department- A Survey of Pediatric Patients and Their Parents. Acad Emerg Med., Dec; 9(12): Report III Contemporary Issues in Medicine: Communication in Medicine: Medical School Objectives Project. October Association of American Medical Colleges. 3. ACGME: Outcome Project General Competencies. RESULTS Acknowledgment: Dr. Nolan, Dr. Kaltreider, Amy Daugherty, MS, Marc Pollack, MD, PhD and Ronald Benenson, MD Approach Patient Receive Verbal Consent Have Patient Identify their Resident from pictures Have patient fill out evaluation 148 patients were surveyed 30 residents were evaluated 8 1 st year residents 11 2 nd year residents 11 3 rd year residents Average of 4.9 surveys per resident Perform statistical tests Spearman Correlation Descriptive Statistics CONCLUSION: Real time patient evaluations of residents’ bedside manner is a promising tool that provides information for constructive resident feedback, changes in residency educational content and data for a 360 o evaluation of core competencies. Future studies would evaluate the effectiveness and reliability of evaluations given at the bedside by comparing different residency programs at York Hospital or ED residents at a separate location. Table 1: Evaluation of Residents communication skills and bedside manner. QuestionYes/Yes Completely Yes Somewhat NoOther Did your Doctor (Dr.) Introduce Him/herself? Did your Dr. introduce him/herself to your family if present? Did you know your Dr. was a resident? Did your Dr. listen carefully w/o interrupting? Did your Dr. ask questions about your problem? Did your Dr. ask you if you had any questions? Did your Dr. answer your questions in a way you could understand? Do you believe your doctor understood your medical problem? If you are having pain, did your Dr. discuss and/or offer treatment for your pain? Did the Dr. talk about you as if you were not there? Did the Dr. explain things about your care or tests in a way you could understand? Was your Dr. supportive of your needs while you were in the ED? Did your Dr. treat you with respect? Do you feel that your Dr. spent enough time with you, discussing your concerns/problems? Did you have confidence and trust in the Dr. who cared for you? Figure 1: Overall satisfaction of patients with their Residents communication skills and professionalism in the Emergency Department. The mean overall rating of communication skills and professionalism on a scale of 0-10, with zero as the lowest score was 9.19 (± S.D. 1.35). Figure 2: Spearman Correlation between overall patient evaluations and individual questions. Only significant correlations are shown.