Background: Communication and interpersonal skills are important for effective patient care but are difficult to measure. Unannounced standardized patient encounters (USPEs) have the benefit of providing a standardized situation and provide a representation of usual care rather than best behavior, while also allowing for video recording without violating patient privacy. We conducted a feasibility pilot study to examine the use of videotaped USPEs in resident education of interpersonal and communication skills and specifically empathy. Methods: This was a pilot study conducted at an urban community teaching hospital. About 16 first-year emergency medicine engaged in four videotaped USPEs during their normal clinical shifts during 1 academic year. All visible recording equipment was concealed from the residents. The standardized patients completed two assessment forms after each encounter to measure empathy. Results: All 16 residents engaged in four videotaped USPEs for a total of 64 encounters. Conclusions: We were able to successfully demonstrate the feasibility of using USPEs for assessment of resident interpersonal and communication skills. E ffective communication is integral to the physician-patient relationship. Studies have shown that empathy in particular improves patient outcomes, results in a decreased rate of litigation, and increases patient and family satisfaction. 1-4 Unfortunately, communication and interpersonal skills are often overshadowed by medical knowledge and procedural skills during medical school and residency. One study found that 26% of interns failed to perform at entry-level milestones related to professionalism and patient-From

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appropriate antibiotic selection with a total of 5,062 patients. Comparator groups for intervention were hours without a pharmacist present in 6 studies, pre-protocol implementation in 9 studies, and alternative provider culture follow-up in 9 studies. Pharmacist involvement in stewardship was associated with a greater likelihood of receiving appropriate antibiotics (OR 3.23; 95% CI 1.98, 5.27). Among methods of intervention, pharmacist presence in the ED (OR 3.13; 95% CI 2.27, 4.32) and pharmacist-led algorithm and education (OR 6.13; 95% CI 2.85, 13.18) were associated with appropriate antibiotics. Pharmacist-led culture review was not significantly associated (OR 1.89; 95% CI 0.88, 4.06). Heterogeneity was high for all assessments.Conclusion: Though the overall quality of evidence was low, it appears that pharmacist involvement in antibiotic stewardship in the ED may significantly improve appropriate antibiotic selection. Pharmacist presence in the ED and pharmacist-led algorithm and education development may have a greater impact than pharmacist-led culture review.

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