Theme: 2JJ Communication
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Enhancing undergraduate students communications skills
Authors: Assisting Teaching Professor M.Jorgensen
Senior Researcher ph.d. K.Witt
E-learning consultant Peter Fridorff-Jens
Institutions: Copenhagen University
Department of Family Medicne
University of Copenhagen,Faculty of Health
 
Background

The investigators have been teaching medical students consultation skills at the last term course in Family Medicine for over twenty years. It has from the start been based on patient-centered medicine (1) as this is associated with improved patient satisfaction, less burn-out in doctors (2) and less use of health care resources (3).During the years we have developed a system for the students to use when analyzing video recordings of consultations, and for optimizing the feed-back process in general.We use a checklist called the DanSCORE based on the assumption that the events in the consultation may be classified in nine steps the consultation.

1.Reason for encounter

2.Patients narrative

3.The professionel filter

4.The diagnostic process

5.Conclusion/diagnosis

6.Options

7.Plan

9 Informed descision

9.Safety net

The Consultation Logic and Analysis as can be found on www.GP-and-Patient.com.

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Summary of Work

Aim:

The aim of the study is to identify the effectiveness of the teaching by registering  the students` consultation skills before and after the Clinical Course in Family Medicine at Copenhagen University, in order to identify the effectiveness of the teaching,

Material and Method:

All student participating in the mandatory Clinicall Course in Family Medicine at the last semester at the Copenhagen University. The students are shown a video of a consultation the very first day of the 5 week course and at the very last day. After watching the video they fill out the 9 steps DanSCORE. The questionnaire contains a total of 40 items.

It is a controlled study, the usual group teaching is used for the control group an usual teaching  plus various forms of interactive e-learning is used for the intervention group.

The  e-learning program consists of 16 brief videos of consultations, accompanied by various questions.The questions were meant to create reflexions and no answers are given.

The students` use of the e-learning program is registered anonymously by the e-learning platform.

 

Results:

By July 1. 2014 553 students have been enrolled. All 553 students present the first day completed the questionnaire day and all  413 present the last day completed the questionnaire.

Discussion:

A further steps will be validating the DanSCORE questionnaire by using teachers from all the medical schools.

 

 

 

 

 

 

Summary of Results

The DanSCORE questionnaire is found a usefull instrument in describing students´ ability to analyse a consultation.

We are in the proces of analysing data.

 

    

 

 

Conclusion

We have designed a useful 9 item questionnaire for describing the students` analysing ability

 

 

References

1.Stewart M, Weston WW, Brown JB, McWhinney IR, McWilliam CL, Freeman TR. Patient-centered Medicine: Transforming the clinical method. Thousand Oaks, CA: Sage Publications; 1995.

2.Kjeldmand D, Holmström I.Balint groups as a means to increase job satisfaction and prevent burnout among general practitioners.Ann Fam Med. 2008 Mar-Apr;6(2):138-45. doi: 10.1370/afm.813.

3.Bertakis KD, Azari R. J Am Board Fam Med. Patient-centered care is associated with decreased health care utilization. 2011 May-Jun;24(3):229-39.

 

 

Take-home Messages

A questionaire measuring  students` ability to analyse consultations has bee developed and found usesful.

Acknowledgement

Copenhagen Medical School has provided the resources,

Background

The teaching is based on the students watching/observing their tutor, and seeing some of the patients in the practice on their own, supervised by the tutor, who is a GP in his own practice. Their consultations are video recorded. At the medical school the students meet once a week in groups of eight under supervision of one of the tutors. At the sessions, the students show their own videos in the group and get feed-back and guidance from the tutor and their fellows in the group.In this process the teachers learned to systematically identify the topics that together describe the content of a consultation.At the exam, the student shows a video of himself in a consultation in the tutor practice with a real patient. He analyzes and discusses the patient’s clinical problems from a general practice perspective and discusses the relevant actions. The communication with the patient is discussed separately as part of the examination.

 

During the years we have established a system for the students to use when analyzing video recordings of consultations, and for optimizing the feed-back process in general. We have developed a system (DanSCORE checklist) to measure the students consultation skills and describe changes when introducing different teaching methods.

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Summary of Work

 

 

 

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Summary of Results

 

2.3.Does the doctor clarify      
Item 2.3   Spring 2013 Autumn 013 
Not relev. a 0% 0%
Too much b 3% 9%
Sufficient c 91% 73%
Too Liitle d 5% 12%
Not ment. e 0% 3%
Does the patient summarize the instruction      
Item 8.1.b   Spring 2013 Autumn 2013
Unnecce. a 7% 7%
Yes b 4% 1%
Partly c 89% 4%
No d 0% 87%
       
Item 10.5   Spring 2013 Autumn 2013
Suff. a 57% 33%
Unsuff. b 15% 32%
Not menti. b 5% 7%
Unfilled in b 22% 20%
Conclusion
References
Take-home Messages
Acknowledgement
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