THANK YOU FOR THIS INTERESTING CONSULT: TEACHING AND ASSESSING INCOMING INTERNS ON CONSULTATION COMMUNICATION VIA ONLINE MODULE AND CONSULTATION OSCE

Dr. Shannon K. Martin, MD, MS*1;Keme Carter, MD1;Noah Hellermann1;Samantha Ngooi, MPP1;Laura Glick, MS22;Jeanne M. Farnan, MD, MHPE1 and Dr. Vineet M. Arora, MD, MAPP3, (1)University of Chicago, Chicago, IL, (2)University of Chicago Pritzker School of Medicine, Chicago, IL, (3)University of Chicago Medicine, Chicago, IL

Meeting: Hospital Medicine 2017, May 1-4, 2017; Las Vegas, Nev.

Abstract number: 34

Categories: Education, Innovations Abstracts

Keywords: , , ,

Background:

Communication is recognized by the LCME and ACGME as an essential competency with significant patient safety implications; the Joint Commission cites communication errors as a major cause of sentinel events. Consultation is a near-universal method of communication between physicians of all disciplines. However, formal education in requesting a consultation is inconsistent in undergraduate medical education (UME).

Purpose:

We aimed to demonstrate the utility of an online training module in presenting a standardized framework for teaching consultation communication to address variability in prior exposure for entering interns, and pilot a novel means for evaluating entering intern performance in requesting a consultation, the consultation OSCE (OSCE).

Description:

We trained all incoming interns on a validated, standardized approach to consultation communication: the 5Cs Model (“Contact”, “Communicate”, “Core Question”, “Collaborate”, “Closing the Loop”). Interns completed an online module, beginning with a survey on UME consultation training, satisfaction with training and self-reported preparedness to request consultations. They were then trained on the 5Cs Model and took a knowledge-based quiz. Following module completion, interns participated in a consultation OSCE (COSCE) during institutional GME orientation where they requested a simulated consult via phone to a trained faculty “standardized consultant”. Faculty evaluated intern performance using a 5Cs checklist and Global Rating Scale. Of 123 interns completing the online module, 78% had requested consults in medical school. 66.4% reported prior UME training in consultation, and 44.8% were satisfied with this training. Satisfaction correlated with pre-survey preparedness; interns highly satisfied with training reported mean preparedness of 4.88 on a 5-point Likert scale compared to interns unsatisfied with training (mean 3.33, P<0.01). Although not statistically significant, satisfaction also correlated with quiz performance, measured by attempts to achieve mastery (i.e., 100% of questions correctly answered). Unsatisfied interns required a mean of 3.33 attempts compared to highly satisfied interns (mean 2.19 attempts). For untrained interns, mean preparedness increased following module completion from 2.79 to 4.0 (P<0.01). Notably, after completing the module, both trained and untrained interns reported similar levels of preparedness and had similar COSCE performances as rated by faculty evaluators.

Conclusions:

The COSCE is a promising strategy for teaching and evaluating entering intern ability to request a consultation. Despite variability in prior exposure to training in consultation, use of an online training module presenting the 5Cs Model as a standardized teaching framework helped mitigate the lack of standardization in UME training and was effective in preparing even untrained interns to request consults.

To cite this abstract:

Martin, SK; Carter, K; Hellermann, N; Ngooi, S; Glick, L; Farnan, JM; Arora, VM . THANK YOU FOR THIS INTERESTING CONSULT: TEACHING AND ASSESSING INCOMING INTERNS ON CONSULTATION COMMUNICATION VIA ONLINE MODULE AND CONSULTATION OSCE. Abstract published at Hospital Medicine 2017, May 1-4, 2017; Las Vegas, Nev. Abstract 34. Journal of Hospital Medicine. 2017; 12 (suppl 2). https://www.shmabstracts.com/abstract/thank-you-for-this-interesting-consult-teaching-and-assessing-incoming-interns-on-consultation-communication-via-online-module-and-consultation-osce/. Accessed September 19, 2019.

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