A human factors curriculum for surgical clerkship students
Department of Family Medicine and Community Health; Department of Surgery; Department of Pediatrics
Adult; Analysis of Variance; Clinical Clerkship; Clinical Competence; *Communication; Confidence Intervals; *Curriculum; Education, Medical, Undergraduate; Educational Measurement; Empathy; Female; General Surgery; Humans; Interprofessional Relations; Intervention Studies; Male; Odds Ratio; *Physician-Patient Relations; Pilot Projects; Professional-Patient Relations; Students, Medical
Community Health and Preventive Medicine | Medical Education | Preventative Medicine | Primary Care | Surgery
HYPOTHESIS: Early introduction of a full-day human factors training experience into the surgical clerkship curriculum will teach effective communication skills and strategies to gain professional satisfaction from a career in surgery.
DESIGN: In pilot 1, which took place between July 1, 2007, and December 31, 2008, 50 students received training and 50 did not; all received testing at the end of the rotation for comparison of control vs intervention group performance. In pilot 2, a total of 50 students were trained and received testing before and after rotation to examine individual change over time.
SETTING: University of Massachusetts Medical School.
PARTICIPANTS: A total of 148 third-year medical students in required 12-week surgical clerkship rotations.
INTERVENTIONS: Full-day training with lecture and small-group exercises, cotaught by surgeons and educators, with focus on empathetic communication, time management, and teamwork skills.
MAIN OUTCOME MEASURES: Empathetic communication skill, teamwork, and patient safety attitudes and self-reported use of time management strategies.
RESULTS: Empathy scores were not higher for trained vs untrained groups in pilot 1 but improved from 2.32 to 3.45 on a 5-point scale (P < .001) in pilot 2. Students also were more likely to ask for the nurse's perspective and to seek agreement on an action plan after team communication training (pilot 1, f = 7.52, P = .007; pilot 2, t = 2.65, P = .01). Results were mixed for work-life balance, with some trained groups scoring significantly lower than untrained groups in pilot 1 and no significant improvement shown in pilot 2.
CONCLUSIONS: The significant increase in student-patient communication scores suggests that a brief focused presentation followed by simulation of difficult patient encounters can be successful. A video demonstration can improve interdisciplinary teamwork.