Allenbaugh Jill, Spagnoletti Carla L, Rack Laurie, Rubio Doris, Corbelli Jennifer
Assistant Professor of Medicine, Division of General Internal Medicine, Lewis Katz School of Medicine at Temple University.
Professor, Department of Medicine, University of Pittsburgh School of Medicine.
MedEdPORTAL. 2019 Jan 18;15:10795. doi: 10.15766/mep_2374-8265.10795.
Communication remains the backbone of patient-provider relationships, and many health outcomes have been directly attributed to both effective and ineffective communication. We developed an educational intervention to improve bedside communication and increase use of health literacy principles, in part as a response to suboptimal inpatient satisfaction scores.
Our intervention consisted of a beside communication curriculum among 37 attending medicine physicians, 76 internal medicine residents, and 85 bedside nurses. The 1- to 1.5-hour curriculum included a didactic session to teach health literacy principles, video demonstrations, group discussion, and role-play. Attending physicians' health literacy knowledge, attitudes, and confidence were evaluated using pre- and postsurveys. Evaluation of the curriculum included Likert-type questions and free-text responses.
Attending physicians' knowledge and confidence improved (74% correct pre, 100% correct post, < .001; 4.41 pre, 4.68 post, = .002, respectively). Certain attitude domains also improved, including importance of team introductions and nurse contributions to bedside rounds ( < .001). Both residents and nurses found the curriculum valuable and planned to incorporate it into their bedside rounding.
A brief, low-cost curricular intervention focusing on clear communication skills and health literacy principles resulted in significant improvements in knowledge and attitudes of attending physicians and was readily incorporated by resident physicians and nurses. This curriculum can be easily implemented in a variety of settings to improve bedside patient-physician communication.
沟通仍然是医患关系的核心，许多健康结果直接归因于有效和无效的沟通。我们开展了一项教育干预措施，以改善床边沟通并增加健康素养原则的应用，部分原因是对住院患者满意度得分不理想做出的回应。
我们的干预措施包括为37名内科主治医师、76名内科住院医师和85名床边护士开展床边沟通课程。这一1至1.5小时的课程包括讲授健康素养原则的理论课程、视频演示、小组讨论和角色扮演。通过课前和课后调查评估主治医师的健康素养知识、态度和信心。对课程的评估包括李克特式问题和自由文本回复。
主治医师的知识和信心有所提高（课前正确率74%，课后正确率100%，P<0.001；课前4.41分，课后4.68分，P = 0.002）。某些态度领域也有所改善，包括团队介绍的重要性以及护士对床边查房的贡献（P<0.001）。住院医师和护士都认为该课程很有价值，并计划将其纳入床边查房。
一项简短、低成本的课程干预措施，聚焦于清晰的沟通技巧和健康素养原则，显著提高了主治医师的知识和态度，并且很容易被住院医师和护士采用。该课程可以在各种环境中轻松实施，以改善床边医患沟通。
