MedEdPORTAL (Mar 2014)
Using a Practice-Based Learning and Improvement Exercise to Assess and Build Basic Patient Care and Communication Skills in Medical Students
Abstract
Abstract Introduction Self-assessment is a major component in medical education and professional development. Physicians can recognize their strengths and challenges through accurate self-assessment, enabling them to focus on needed areas for improvement. This exercise is designed to be conducted with third-year medical student approximately 12 weeks into the year, and is designed to address the ACGME competencies of patient care, interpersonal and communication skills, and practice-based learning and improvement. Methods This forty-five minute exercise incorporates a one-to-one student-faculty joint review of a video of a single student-patient encounter. Before the video is played, both the faculty member and student review the presenting situation depicted. The video is then viewed and both the student and faculty member and fill out provided feedback forms. The feedback is then shared and the student completes an action plan. Results In the evaluation of this exercise by the medical students, the quality of the session received an average score of 4.4 out of 5, and the amount of new information gained received a 4.2 out of 5. In examining the topics for the student action plans, approximately 45% of the items related to encounter management (primarily time management and organization of the encounter), 30% were related to the competency of patient care (divided between history, physical examination and desire to provide a better list of differential diagnoses); while the remaining 25% noted interpersonal or communication skills that could be optimized. Discussion The focus of this exercise is twofold: (1) student metacognitive skills and (2) basic doctor-patient encounter skills. The metacognitive skills include skills in self-review, self-assessment, and self-management. The doctor-patient encounter skills include the skills of eliciting a focused history, conducting a focused physical examination, and the usage of both case-specific interpersonal and communication skills.
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