Eric Barna, MD, associate residency program director, Inpatient Medicine, Division of Hospital Medicine/Samuel Bronfman Department of Medicine, Icahn School of Medicine at Mount Sinai Hospital
As a hospitalist at Mount Sinai Hospital in New York, New York, I'm part of a team that cares for moderately to severely ill patients. I'm also a physician advisor, and I have the pleasure of teaching some of the youngest and brightest medical students, interns, and residents at various stages of their careers. I consider this the best part of my work, so I'm sure it comes as no surprise that I'm a firm believer in the importance of continuous learning.
That's why I was so excited when I had the chance to participate in three standardized patient (SP) encounters training designed for me and my 22 hospitalist colleagues to improve our communication skills, funded by a grant from The Doctors Company Foundation. A standardized patient encounter is a live simulation in a clinical setting with trained actors. A physician is given a short prompt about the patient scenario. They may also be provided with some basic information such as a diagnosis or a relevant imaging study prior to entering the room. Once the testing center provides a signal, physicians are allowed to enter the room. An introduction of our role on the medical team is provided and a discussion ensues. The actors provide relevant history, incorporate true emotional response to questioning and display any behavioral or physical prompts that a real patient would. This allows physicians to react in real time to the needs of the patient. The use of standardized patients can also be adapted to desired testing scenarios, whether in the realm of communication, clinical reasoning, or establishing a differential diagnosis.
Like many hospitals, we have a program in place aimed at assessing how we educate students and younger physicians. But Mount Sinai is the first hospital in New York that has established a program designed specifically to assess and address some of the unique communication challenges we face as hospitalists to improve patient care.
Strengthening individual communication skills is paramount to improving patient comprehension, which in turn can improve patient follow-though on discharge instructions and reduce risk of readmission. And as educators, our takeaways from the training can empower others in the healthcare system at large to better communicate with their patients.
Since the initial date of the training, the three modules have expanded into a program run by The Morchand Center for Clinical Competence at the Icahn School of Medicine at Mount Sinai. So far, the Morchand Center has adapted the SP methodology for hospitalists to train 1,845 additional residents in various specialties across New York City.
Nationwide, the entire medical community stands to benefit from continuous physician learning and partnerships that facilitate it, like The Doctors Company, which makes trainings like this possible. At a time of tremendous change for healthcare, having a well-trained physician workforce is more important than ever before.
Tips to Improve Hospitalist/Patient Communication
- Sit down to establish "eye level" communication.
- Introduce yourself and your role.
- Avoid using medical jargon, such as e.g. "upper respiratory infection" instead of "cold."
- Ask patients to explain their understanding of the care being provided.
- Always close an encounter by asking a patient if there is anything they would like to discuss.
- Eric Barna, MD