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Comparing resident–patient encounters and case presentations in a family medicine clinic
Author(s) -
Skelly Kelly,
Rosenbaum Marcy,
Barlow Patrick,
Priebe Garrick
Publication year - 2019
Publication title -
medical education
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.776
H-Index - 138
eISSN - 1365-2923
pISSN - 0308-0110
DOI - 10.1111/medu.13806
Subject(s) - competence (human resources) , communication skills , medicine , perspective (graphical) , presentation (obstetrics) , medical education , communication skills training , social skills , simulated patient , psychology , family medicine , nursing , social psychology , psychiatry , artificial intelligence , computer science , radiology
Objectives Oral case presentations following resident–patient interactions provide the primary mechanism by which faculty supervisors assess resident competence. However, the extent to which these presentations capture the content and quality of resident–patient communication during the encounter remains unknown. We aimed to determine whether: (i) the resident–patient encounter content matched information conveyed in the case presentation; (ii) the quality of resident–patient communication was accurately conveyed, and (iii) supervisors addressed effective and ineffective communication processes. Methods A total of 22 pairs of resident–patient encounters and family medicine resident case presentations were video‐ or audiorecorded, transcribed and compared for content. Resident–patient communication was assessed using adapted versions of the Calgary–Cambridge Guide to the Medical Interview and Explanation and Planning Scale. Results Interviews and presentations contained largely congruent content, but social history and the patient's perspective were consistently excluded from case presentations. Although six of 19 specific communication skills were used in over 80% of resident encounters, the effective use of communication skills was widely variable. In most presentations, the quality of resident–patient communication was not explicitly conveyed to the supervisor. Although resident presentations provided ‘cues’ about communication issues, supervisors rarely responded. Conclusions This study lends support to direct observation in workplace‐based learning of communication skills. When content areas such as the patient's perspective and education are excluded, supervisors cannot address them. In addition, presentations provided minimal insight about the quality of resident–patient encounters and limited the ability to address communication skills. These skills could be enhanced by attending to communication cues during case presentations, making increased use of direct observation and feedback, and promoting faculty development to address these missed teaching opportunities.