Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health

Introduction: Despite the extraordinary amount of time physicians spend communicating withpatients, dedicated education strategies on this topic are lacking. The objective of this study was todevelop a multimodal curriculum including direct patient feedback and assess whether it improvescommunication skills as measured by the Communication Assessment Tool (CAT) in fourth-yearmedical students during an emergency medicine (EM) clerkship.

Methods: This was a prospective, randomized trial of fourth-year students in an EM clerkship atan academic medical center from 2016-2017. We developed a multimodal curriculum to teachcommunication 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 emergencydepartment setting. The intervention group received the curriculum at the clerkship midpoint. Thecontrol group received the curriculum at the clerkship’s end. We calculated proportions and oddsratios (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 interventiongroup. The percentage of students achieving the maximum CAT score was similar between groupsduring the first half (OR 0.70, p = 0.15). Following the intervention, students in the intervention groupachieved 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 communicationcompared to the control group. A multimodal curriculum involving direct patient feedback may be aneffective means of teaching communication skills.