A Brief Communication Curriculum Improves Resident and Nurse Communication Skills and Patient Satisfaction

Abstract

Background: Despite the ever-expanding role that the patient experience plays in healthcare, effective strategies proven to increase patient satisfaction ratings remain scarce. At the University of Pittsburgh Medical Center, we identified patient-doctor and patient-nurse communication as an area for intervention to improve suboptimal patient satisfaction among medicine inpatients. We posited that the likely reasons for underperformance in this area were a lack of adequate training in bedside communication skills.

Design: We developed and evaluated a curriculum for medicine residents and nurses focused on clear communication at the bedside. A total of 76 internal medicine residents and 85 medical service nurses participated in 2016. The curriculum utilized didactics, video demonstrations, and role play, and was evaluated using pre- and post-surveys of participants' health literacy knowledge, attitudes, and confidence. Communication skills were evaluated using pre- and post-direct observation at the bedside with a communication skills checklist. Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores were compared 3 months before and after the curriculum to assess changes in patient satisfaction.

Key results: Knowledge and attitudes improved significantly for both residents and nurses. Residents' and nurses' observed clinical communication skills improved significantly in most domains, and there was moderate increase in communication-specific HCAHPS scores.

Conclusion: A small investment of curricular time devoted to clear communication skills improved residents' and medical nurses' knowledge, attitudes, skills, and communication-specific HCAHPS scores. This curriculum, focused on improving bedside communication skills, could be implemented in a variety of settings to improve patient satisfaction and patient experience.

Keywords: communication skills; health literacy; medical education; medical education–curriculum development/evaluation; patient satisfaction.

Figure 1

Percentage change in pre-intervention time period vs post-intervention time period “top-box” HCAHPS scores in physician and nurse communication (corresponding to answer choice of “Always”) from patients discharged from medical (intervention participants) and surgical (non-participants) wards. “Overall communication” represents the average of the top-box HCAHPS scores for the doctor- and nurse-specific communication HCAHPS questions. “Explained” represents the HCAHPS item, “Your doctor/nurse explained things to you in a way you could understand.” “Listened” represents the HCAHPS item, “Your doctor/nurse listened carefully to you.” “Courtesy and Respect” represents the HCAHPS item, “Your doctor/nurse treated you with courtesy and respect.” “Understanding Medication” represents the HCAHPS item, “When I left the hospital, I clearly understood the purpose for taking each of my medications.” “Understanding Health” represents the HCAHPS item, “When I left the hospital, I had a good understanding of the things I was responsible for in managing my health.” Figure 1 contains poor quality of text inside the artwork. Please do not re-use the file that we have rejected or attempt to increase its resolution and re-save. It is originally poor, therefore, increasing the resolution will not solve the quality problem. We suggest that you provide us the original format. We prefer replacement figures containing vector/editable objects rather than embedded images. Preferred file formats are eps, ai, tiff and pdf.Unfortunately none of my colleagues or I have the ability to change the figure. I have attempted to make a new copy from the source data, please let me know if this is better, or if it will still be an issue.Thank you.