Education Research: Introduction of a Standardized Communication Card to Facilitate Patient-as-Teacher Training for Medical Students in the Neurology Clerkship.

BACKGROUND AND OBJECTIVES

Enhanced communication has been recognized as an effective strategy to improve patient safety and care quality. While some communication skills can be taught in traditional didactic settings, learning from patient encounters is critical. Currently, patients are becoming increasingly involved as teachers for medical students within both the clinical and classroom setting. The goal of this study was to characterize medical student reflections about patient interactions using a standardized Patient and Teacher Communication Card. We aimed to identify how the introduction of this tool changed students' follow-up practices and affected patient care.

METHODS

We used a cross-sectional concurrent mixed-methods study to characterize student-patient communication. Medical students taking the neurology clerkship between 2017 and 2022 were asked to complete the Communication Card during at least 1 patient encounter. The Communication Card was used to generate a learning opportunity by providing questions for the students to ask the patient. Following the encounter, the card collected qualitative data from the student's perspective through 2 open-ended questions: (Q1) How has the card changed how you follow-up with patients after rounds? (Q2) How did this follow-up affect patient care? We used a conventional content analysis approach to characterize student responses.

RESULTS

A total of 460 students completed the card (MS2: n = 67 [14.6%]; MS3: n = 260 [56.5%], and MS4: n = 133 [28.9%]). Students cited 4 ways in which the card changed their follow-up with patients: (1) ensuring understanding; (2) following up more; (3) building rapport; and (4) guiding challenging conversations. Ensuring understanding was cited by half of the students in all years. Students cited ways in which the card affected patient care: (1) prompting further discussion with the team and/or patient; (2) impression of the patient feeling more comfortable; (3) addressing patient concerns; and (4) impression of increased trust.

DISCUSSION

Overall, students' reflections after patient conversations were very positive. Future work should consider studying the impact of this communication tool on patients' perspectives and determine whether they align with the student's perception. In addition, implementation of a Communication Card throughout the other clerkships should be considered to enhance the medical school curriculum.