A Multimodal Curriculum With Patient Feedback to Improve Medical Student Communication: Pilot Study

Abstract

Introduction: Despite the extraordinary amount of time physicians spend communicating with patients, dedicated education strategies on this topic are lacking. The objective of this study was to develop a multimodal curriculum including direct patient feedback and assess whether it improves communication skills as measured by the Communication Assessment Tool (CAT) in fourth-year medical students during an emergency medicine (EM) clerkship. Methods: This was a prospective, randomized trial of fourth-year students in an EM clerkship at an academic medical center from 2016-2017. We developed a multimodal curriculum to teach communication skills consisting of 1) an asynchronous video on communication skills, and 2) direct patient feedback from the CAT, a 15-question tool with validity evidence in the emergency department setting. The intervention group received the curriculum at the clerkship midpoint. The control group received the curriculum at the clerkship’s end. We calculated proportions and odds ratios (OR) of students achieving maximum CAT score in the first and second half of the clerkship. Results: A total of 64 students were enrolled: 37 in the control group and 27 in the intervention group. The percentage of students achieving the maximum CAT score was similar between groups during the first half (OR 0.70, p = 0.15). Following the intervention, students in the intervention group achieved a maximum score more often than the control group (OR 1.65, p = 0.008). Conclusion: Students exposed to the curriculum early had higher patient ratings on communication compared to the control group. A multimodal curriculum involving direct patient feedback may be an effective means of teaching communication skills.

INteractive Virtual Expert-Led Skills Training: A Multi-Modal Curriculum for Medical Trainees

“…With an overall paucity internationally of CAP subspecialists ( 13 – 16 , 34 , 36 ) and the critical rates of pediatric depression and suicidality ( 1 , 3 , 4 ), there is a critical need for primary care clinicians to develop competency in screening and basic assessment of conditions traditionally managed by subspecialists, including mental and behavioral health disorders such as depression and suicidality ( 8 , 14 , 18 , 19 , 48 , 57 ). To address this need, we developed our INVEST curriculum, a virtually-delivered, synchronous medical education program ( 8 , 17 , 19 , 22 , 24 , 30 , 40 , 41 ) leveraging mixed technology ( 10 ) to bring subspecialty content to a diverse audience of medical students and residents. We applied our multimodal structure to focus on delivery of key skills in assessing pediatric depression and suicidality in the primary care setting ( 20 , 50 ) through video modeled best practice with CAP subspecialist-led discussion.…”

“…Developed by a multidisciplinary team of subspecialists at Indiana University School of Medicine (IUSM), our curriculum was designed as a fully virtual multimodal training curriculum ( 8 , 17 , 19 , 22 , 24 , 30 , 40 , 41 ) delivered by CAP faculty members. Multimodal trainings ( 20 , 22 , 42 ) use a variety of curriculum delivery methods in a single training (e.g.…”

“…However, primary care providers ( 18 , 19 ) and residents in primary care residency training programs ( 17 , 20 , 21 ) report inadequate knowledge and skill in the assessment, diagnosis and treatment of these areas. To care for these patient needs, medical providers must acquire basic competence in pediatric mental and behavioral health ( 14 , 22 ), including development of both interpersonal communication skills ( 23 ) and content knowledge ( 24 – 26 ).…”

A Curriculum, Instruction, and Assessment (CIA) Framework for Health Literacy Education (HLE) in Medical and Health Professions Schools

“…One example of a participatory method for multimodal communication includes a pediatric workshop on how to build rapport with patients during an emotionally charged exchange using the mnemonic: Take the HEAT which stands for "hear me out, empathize, apologize, and take action" (Marsh, Reed, Mahan, Schneider, Fernandes, Liao, Spears, & Lauden, 2021). Another example of a multimodal curriculum with patient feedback showed promising results in improved communication skills among fourth-year medical students when compared to a control group (Dubosh, Hall, Novack, Shafat, Shapiro, & Ullman, 2020).…”

Design and Evaluation of a Curriculum on Intimate Partner Violence for Medical Students in an Emergency Medicine Clerkship

“…We used an asynchronous approach based on previous work demonstrating its efficacy in adult learners. [29][30][31] Part one consisted of an online 20-minute educational video which was distributed via email and viewed asynchronously prior to the in-person session. The content included an introduction to the topic, overview of definitions and prevalence of IPV, review of potential health consequences, introduction to screening practices, and next steps and resources available when a patient discloses IPV.…”