Medical student use of communication elements and association with patient satisfaction: a prospective observational pilot study

Joseph S. Turner, Katie E. Pettit, Bryce B. Buente, Aloysius J. Humbert, Anthony J. Perkins, Jeffrey A. Kline

Effective communication with patients impacts clinical outcome and patient satisfaction. We measure the rate at which medical students use six targeted communication elements with patients and association of element use with patient satisfaction. Participants included fourth year medical students enrolled in an emergency medicine clerkship. A trained observer measured use of six communication elements: acknowledging the patient by name, introducing themselves by name, identifying their role, explaining the care plan, explaining that multiple providers would see the patient, and providing an estimated duration of time in the emergency department. The observer then conducted a survey of patient satisfaction with the medical student encounter. A total of 246 encounters were documented among forty medical student participants. For the six communication elements evaluated, in 61 % of encounters medical students acknowledged the patient, in 91 % they introduced themselves, in 58 % they identified their role as a student, in 64 % they explained the care plan, in 80 % they explained that another provider would see the patient, and in only 6 % they provided an estimated duration of care. Only 1 encounter (0.4 %) contained all six elements. Patients' likelihood to refer a loved one to that ED was increased when students acknowledged the patient and described that other providers would be involved in patient care (P = 0.016 and 0.015 respectively, Chi Square). Likewise, patients' likelihood to return to the ED was increased when students described their role in patient care (P = 0.035, Chi Square). This pilot study demonstrates that medical students infrequently use all targeted communication elements. When they did use certain elements, patient satisfaction increased. These data imply potential benefit to additional training for students in patient communication.