Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jun 21;31(4):1429-1439.
doi: 10.1007/s40670-021-01331-w. eCollection 2021 Aug.

The Development of a Video Intervention to Improve Senior Medical Students' Performance on Outpatient Telephone Encounters: a Delphi Analysis and Randomized Controlled Trial

Jacob A Mack  1 , Helen K Morgan  2   3 , James T Fitzgerald  3 , Eric C Walford  4 , Lauren A Heidemann  1
Affiliations

The Development of a Video Intervention to Improve Senior Medical Students' Performance on Outpatient Telephone Encounters: a Delphi Analysis and Randomized Controlled Trial

Jacob A Mack et al. Med Sci Educ. .

Abstract

Introduction: Postgraduate trainees address outpatient telephone calls (OTCs) with little prior training. This study determines the skills necessary for OTCs and examines whether a video intervention improves medical students' performance on simulated OTCs.

Materials and methods: We utilized a Delphi technique to determine skills needed for OTCs and created a 9-min video teaching these skills. Senior medical students were randomized to Intervention (viewed video) and Control (did not view video) groups. Students were assessed pre-/post-intervention on simulated OTCs. The primary outcome was the between-group difference in improvement.

Results: The Delphi yielded 34 important skills with the highest focus on communication (n = 13) and triage (n = 6). Seventy-two students completed assessments (Control, n = 41; Intervention, n = 31). The score (mean ± SD) improved 4.3% in the Control group (62.3 ± 14.3% to 66.6 ± 25.0%) and 12.2% in the Intervention group (60.7 ± 15.2% to 72.9 ± 20.4%, p = 0.15). The effect size measured by Cohen's d was 0.55, considered effective (> 0.33) for an educational intervention.

Conclusions: This project fills a gap in OTC training. The use of the Delphi technique, intervention development based on the results, and evaluation of efficacy is a process that could be reproduced for other educational gaps.

Supplementary information: The online version contains supplementary material available at 10.1007/s40670-021-01331-w.

Keywords: Delphi technique; Mock paging; Randomized controlled trial; Residency preparation course; Transition to residency.

PubMed Disclaimer

Conflict of interest statement

Conflict of InterestThe authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Randomized controlled trial protocol. Students were first stratified within their Residency Preparation Courses (RPCs) then randomized. Then, both Intervention and Control groups were assessed with Mock Page 1. Subsequently, the Intervention group received the educational video and both groups were again assessed with Mock Page 2. Analysis was conducted according to the intention-to-treat principle. RPC residency preparation course, FM family medicine, IM internal medicine, OB/GYN obstetrics and gynecology, Peds pediatrics, Surg surgery
Fig. 2
Fig. 2
Plot of student overall scores. Each student’s scores are plotted for Mock Page 1 and Mock Page 2 with a line connecting the scores. OTC outpatient telephone call
Fig. 3
Fig. 3
Select images from the educational video intervention which describe a the three main components for caring for patients remotely, i.e., b the setting in which the encounter takes place, c the interaction with the patient, and d foundational knowledge and skills
See this image and copyright information in PMC

References

    1. Killip S, Ireson CL, Love MM, Fleming ST, Katirai W, Sandford K. Patient safety in after-hours telephone medicine. Fam Med. 2007;39:404–409. - PubMed
    1. Hannis MD, Elnicki DM, Morris DK, Flannery MT. Can you hold please? How internal medicine residents deal with patient telephone calls. Telephone Encounters Learning Initiative Group. Am J Med Sci 1994;308:349–52. 10.1097/00000441-199412000-00007. - PubMed
    1. Flannery MT, Moses GA, Cykert S, Ogden PE, Keyserling TC, Elnicki DM, et al. Telephone management training in internal medicine residencies: a national survey of program directors. Acad Med J Assoc Am Med Coll. 1995;70:1138–1141. doi: 10.1097/00001888-199512000-00018. - DOI - PubMed
    1. Cykert S, Flannery MT, Huber EC, Keyserling T, Moses GA, Elnicki DM, et al. Telephone medical care administered by internal medicine residents: concerns of program directors and implications for residency training. Am J Med Sci. 1997;314:198–202. doi: 10.1097/00000441-199709000-00009. - DOI - PubMed
    1. Daniel H, Sulmasy LS. Health and Public Policy Committee of the American College of Physicians. Policy recommendations to guide the use of telemedicine in primary care settings: an American College of Physicians position paper. Ann Intern Med 2015;163:787–9. 10.7326/M15-0498. - PubMed

LinkOut - more resources