House staff communication training and patient experience scores

Abstract

Objective: To assess whether communication training for housestaff via role-playing exercises (1) is well-received and (2) improves patient experience scores in housestaff clinics.

Methods: We conducted a pre-post study in which the housestaff for 3 adult hospital departments participated in communication trainingled by trained faculty in small groups . Sessions centered on a published 5-step strategy for opening patient-centered interviews using department-specific role-playing exercises. Housestaff completed post-training questionnaires. For one month prior to and one month following the training, patients in the housestaff clinics completed surveys with CG-CAHPS questions regarding physician communication, immediately following clinic visits. Pre-and post -intervention results for top-box scores were compared.

Results: Forty -four of a possible 45 housestaff (97.8%) participated, with 31 (70.5%) indicating that the role-playing exercise increased their perception of the 5-step strategy. No differences on patient responses to CG-CAHPS questions were seen when comparing 63 pre-intervention patients surveys to 77 post-intervention surveys.

Conclusion: Demonstrating an improvement in standard patient experience surveys in resident clinics may require ongoing communication coaching and investigation of the "hidden curriculum" of training.

Keywords: Communication; education; medical residencies; patient satisfaction.

Figure 1.

Details of the 5-step method for opening patient interviews that was taught during the study’s training sessions. Adapted from Smith (8).

Figure 2.

A sample case from the role-playing exercises that house staff participated during the study. For each case, each of the 3 residents in a small group had a specific role to play: (1) the doctor, (2) the patient, or (3) the observer, that is, the person responsible for feedback to the resident playing the doctor, after the scenario. After each scenario, the residents rotated their roles and repeated the exercise with a new case, until all residents in each small group had participated in all 3 roles.