Measuring the Impact of an Interactive Communication Skills Curriculum on Internal Medicine Residents: A Cluster Randomized Educational Study
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 411
- 试验地点
- 1
- 主要终点
- Communication Assessment Tool (CAT)
研究概览
简要总结
This study seeks to assess whether a novel method of teaching communication skills is effective in improving the communication skills of internal medicine residents. Effective communication is widely accepted as an essential skill in both clinical practice and post-graduate training. While the body of research on effective communication is maturing, training that incorporates this new data lags behind. Methodological difficulties inherent to the study of communication training programs further complicates the effort to create effective, evidence-based training programs for the next generation of practitioners. Cleveland Clinic has taught its internally developed relationship-centered communication model, the R.E.D.E. Model, to over 7000 providers in less than 5 years. While teaching this course, common communication themes emerged as areas where providers often "get stuck". This proposal details a cluster randomized educational study of a novel communication training curriculum that addresses 3 of the common communication themes that emerged and how those themes occur in multiple, different communication challenges. The curriculum will be delivered to 2nd and 3rd year internal medicine residents over three, 1-hr long training sessions. The investigators' primary aim is to test whether residents trained to identify and communicate through these themes will receive better scores on communication from patients seen in their general internal medicine clinic. The investigators will also assess the effect of this training on patient compliance and on management of common chronic diseases such as hypertension, depression, and diabetes. Lastly, the investigators will measure the effect of the training course on resident self-perceived burnout and empathy.
详细描述
This trial employed a cluster-randomized design. The residency program randomly divides the residents into 5 groups when they arrive as interns. These groups receive lectures together for all three years of residency and have similar schedules. The investigators used this predetermined structure to randomize the residents' communication course for this study. Two of the five groups were selected using a random number generator to receive the control course and three of the five groups received the intervention course. Although participation in the research study was voluntary, attending the assigned communication course was a mandatory educational activity for the residents.
Control (standard) Course:
The control course consisted of three hour-long didactic lectures on delivering bad news, discussing prognosis, and talking to patients about pain. The majority of time in these lectures was spent on didactic material. Little, if any, time was spent practicing skills or on interactive skill building. The three parts of the course were delivered over a 4-month period.
Intervention Course:
The intervention course also consisted of three hour-long sessions on communication delivered over a 4-month period. It differed from the control course in subject matter and pedagogy. Subject matter focused on specific skills used in communication: reflective listening, responding to emotion, and providing information within a broad range of communication scenarios. In terms of pedagogy, the intervention course was interactive with a focus on skills practice, communication drills, and improvisation to engage learners. The sessions consisted of fifteen minutes of lecture and 45 minutes of skills practice.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Other
- 盲法
- Double (Participant, Care Provider)
盲法说明
Resident participants did not know which curriculum was intervention and which was control. Patient participants did not know what communication curriculum their resident physician had completed.
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Appointment scheduled with a resident participant at one of eight primary care clinics in our health system
- •had completed an appointment with a resident participant within 2 months of the resident completing their communication course
- •18 years of age or older
- •proficient in English
- •PGY2 and PGY3 Internal Medicine residents at Cleveland Clinic
- •Scheduled to receive required educational curriculum on communication
- •Scheduled to see patients at one of the eight primary care clinics in our health system
排除标准
- •No appointment scheduled with a resident participant at one of eight primary care clinics in our health system
- •had not completed an appointment with a resident participant within 2 months of the resident completing their communication course
- •Less than 18 years of age
- •Not proficient in English
- •Not PGY2 and PGY3 Internal Medicine residents at Cleveland Clinic
- •Not scheduled to receive required educational curriculum on communication
- •Not scheduled to see patients at one of the eight primary care clinics in our health system
研究组 & 干预措施
Intervention Curriculum
The intervention course consisted of 3 hour-long sessions on communication delivered over a 4-month period. It differed from the control course in subject matter and pedagogy. Subject matter focused on specific skills used in communication: reflective listening, responding to emotion, and providing information within a broad range of communication scenarios. In terms of pedagogy, the intervention course was interactive with a focus on skills practice, communication drills, and improvisation to engage learners. The sessions consisted of fifteen minutes of lecture and 45 minutes of skills practice.
干预措施: Communication Skills Curriculum (Other)
Control (Standard) Curriculum
The control course consisted of three hour-long didactic lectures on delivering bad news, discussing prognosis, and talking to patients about pain. The majority of time in these lectures was spent on didactic material. Little, if any, time was spent practicing skills or on interactive skill building. The three parts of the course were delivered over a 4-month period.
干预措施: Communication Skills Curriculum (Other)
结局指标
主要结局
Communication Assessment Tool (CAT)
时间窗: 2-12 weeks after primary care appointment
The CAT is a fifteen item survey measuring physician communication as perceived by patients. Each item is rated from 1 "Poor" to 5 "Excellent". The first fourteen items measure specific aspects of communication, and the last item measures the quality of communication overall. Because surveys such as this are subject to a ceiling effect, scores were also analyzed as the percent of questions that received the maximum score - also known as a "top box" score.
次要结局
- Patient Activation Measure (PAM13)(2-12 weeks after primary care appointment)