Teaching patient-centered communication skills: a telephone follow-up curriculum for medical students

Abstract

Background

To encourage medical students’ use of patient-centered skills in core clerkships, we implemented and evaluated a Telephone Follow-up Curriculum focusing on three communication behaviors: tailoring education to patients’ level of understanding, promoting adherence by anticipating obstacles, and ensuring comprehension by having patients repeat the plans.

Methods

The intervention group consisted of two different cohorts of third-year medical students in longitudinal clerkships (n=41); traditional clerkship students comprised the comparison group (n = 185). Intervention students telephoned one to four patients 1 week after seeing them in outpatient clinics or inpatient care to follow up on recommendations. We used surveys, focus groups, and clinical performance examinations to assess student perception, knowledge and skills, and behavior change.

Results

Students found that the curriculum had a positive impact on patient care, although some found the number of calls excessive. Students and faculty reported improvement in students’ understanding of patients’ health behaviors, knowledge of patient education, and attitudes toward telephone follow-up. Few students changed patient education behaviors or called additional patients. Intervention students scored higher in some communication skills on objective assessments.

Conclusion

A patient-centered communication curriculum can improve student knowledge and skills. While some intervention students perceived that they made too many calls, our data suggest that more calls, an increased sense of patient ownership, and role modeling by clerkship faculty may ensure incorporation and application of skills.

• education
• medical
• undergraduate
• clinical clerkship
• patient-centered care
• physician–patient relationship
• continuity of patient care

Acknowledgements

We would like to thank the participating faculty members and students in the VALOR and LIC clerkships, and Bernie Miller (Director of the Standardized Patient Program at UCSF).

Conflict of interest and funding

This project was supported by a grant K07AT003131 from the National Institutes of Health/National Center for Complementary and Alternative Medicine and by the University of California, San Francisco Academy of Medical Educators.