Abstract
Introduction:
Hospital inpatients can present as confused for a multitude of reasons, thus learning how to effectively communicate with confused patients is a key skill for medical students. Fourth year is the first clinical year at our medical school. A verbal feedback session with fourth year medical student year representatives identified confidence in communicating with confused patients as a key concern of the cohort.
Methods:
40 fourth year medical students were surveyed using an online form. The students rated their confidence in communicating with confused patients on a Likert scale, and were asked to explain this answer in under 100 words. These responses were collated into a Microsoft Excel Spreadsheet, and then thematic analysis using NVivo 12 software was applied to identify key themes.
Results:
20% (8/40) of students rated themselves as ‘very unconfident’, 33% (13/40) as ‘somewhat unconfident’, 38% (15/40) as ‘neither confident or unconfident’, 7% (3/40) as ‘somewhat confident’, and 2% (1/40) as ‘very confident’. Key challenges identified by students included: unclear patient understanding or capacity (16 references), student communication style (15 references), patient distress or agitation (9 references), obtaining accurate information (7 references), and misunderstanding the patient (7 references).
An e-learning resource including videoed simulated scenarios was created to attempt to address these challenges. 24 students who undertook the e-learning were surveyed at the end of the module. 4% (1/24) rated themselves as ‘neither confident or unconfident’, 88% (21/24) as ‘somewhat confident’, and 8% (2/24) as ‘very confident’, with no students rating themselves as ‘very unconfident’ or ‘somewhat unconfident’.
Conclusion:
Medical students at the beginning of their clinical years lack confidence and identify several key challenges in communicating with confused patients. An understanding of these challenges is important for those working in Geriatric Medicine, particularly those involved in medical education. E-learning and utilizing technology can be a helpful tool in developing students’ learning and confidence in this area.
Comments
This is a really helpful…
Great points to highlight…
Great points to highlight especially as geriatric medicine is embedded within most other specialties to some extent! E-learning can be a useful introductory tool to this particular clinical environment. Perhaps in future iterations for the more advanced learner this could be expanded to communicating with patients who may be agitated and de-escalation methods.
Important work
Really amazing, highlights the issues early on so we can tackle them before clinical years!
Great poster
Well done, this highlights an important area for training and exposure that goes beyond 'book learning'!
Really interesting project…
Really interesting project. I work in medical education and interaction with the confused patient is a common fear for our medical students. Your eLearning sounds like a great idea to recognise this issue and provide some resolve. I think it would be useful to bring this concept into the classroom, perhaps through some face-to-face cased based learning or perhaps even clinical simulation. I wonder if this would help bring theoretical knowledge into real life - thus consolidating learning.