Evaluating first year residents’ communication skills: a health literacy curriculum needs assessment

ABSTRACT

Background

High quality communication skills are necessary for competent and ethical practice. When patients present with low health literacy, physicians’ skills may be lacking, which can put patients’ safety and satisfaction at risk. The authors’ developed and executed a simulation-based needs assessment following conflicting internal reports about the communications skills of new residents.

Methods

The current study recruited first year residents (N = 30) during the 2019 first post-graduate year (PGY-1) orientation at a southeastern university hospital simulation center. The residents completed an Objective Structured Clinical Examination (OSCE) which focused on obtaining informed consent from a patient’s health care proxy who presented with limited literacy and health literacy and poor communication skills. After completing the OSCE, the residents, simulated patients (SP), and independent observers assessed the residents’ performance.

Results

Residents assessed their performance higher when compared with the ratings from independent observers and patient raters. Residents who spent more time with SPs were given higher ratings by the SPs and independent observers. Finally, residents’ ratings of themselves had a positive correlation with their reported confidence, but no correlation between self-confidence and the ratings provided by SPs or observers.

Conclusion

PGY-1 residents demonstrate a continued need for health literacy and informed consent education, despite faculty believing that these skills were covered enough in medical school. These residents also demonstrated limited self-assessment ability or skills below the expectations of health literacy experts. Curriculum changes included improving the focus on health literacy, communication skills, and additional practice opportunities throughout their internship year.

KEYWORDS:

• Health literacy
• internship and residency
• informed consent
• curriculum
• simulation training

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1 Adapted from (27,28)

2 Adapted from (29-31)

3 Adapted from (30,32)

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.

Notes on contributors

Zach Budesa

Zach Budesa, PhD is the Research and Assessment Coordinator for the University of Tennessee Center for Advanced Medical Simulation in Knoxville, TN. Melinda Klar is the Administrative Director for the University of Tennessee Center for Advanced Medical Simulation in Knoxville, TN. Sujata Datta is a resident at the University of Maryland Medical Center in Baltimore, MD. Emily Moore is a medical student at Lincoln Memorial University in Knoxville, TN. Leonard Lamsen is the Medical Director for the University of Tennessee Center for Advanced Medical Simulation in Knoxville, TN.