A metric-based analysis of structure and content of telephone consultations of final-year medical students in a high-fidelity emergency medicine simulation

Abstract

ObjectivesIn this study we aimed to analyse the structure and content of telephone consultations of final-year medical students in a high-fidelity emergency medicine simulation. The purpose was to identify any areas of deficiency within structure and content in the effective transfer of clinical information via the telephone of final-year medical students.DesignAn educational study.SettingSimulation centre in a medical school.Participants113 final-year medical students.Primary and secondary outcomesThe primary outcome was to analyse the structure and content of telephone consultations of final-year medical students in a high-fidelity emergency medicine simulation. The secondary outcome was to identify any areas of deficiency within structure and content in the effective transfer of clinical information via the telephone of final-year medical students.ResultsDuring phone calls to a senior colleague 30% of students did not positively identify themselves, 29% did not identify their role, 32% did not positively identify the recipient of the phone call, 59% failed to positively identify the patient, 49% did not read back the recommendations of their senior colleague and 97% did not write down the recommendations of their senior colleague.ConclusionsWe identified a deficiency in our students skills to communicate relevant information via the telephone, particularly failure to repeat back and write down instructions. We suggest that this reflects a paucity of opportunities to practice this skill in context during the undergraduate years. The assumption that this skill will be acquired following qualification constitutes a latent error within the healthcare system. The function of undergraduate medical education is to produce graduates who are fit for purpose at the point of graduation.

A Literature Study of Medical Simulations for Non-Technical Skills Training in Emergency Medicine: Twenty Years of Progress, an Integrated Research Framework, and Future Research Avenues

“…Through applying an effective communication strategy, the authors demonstrated the positive effects of high-fidelity simulation on self-efficacy and knowledge transfer. Depending on the adequacy of the solution, the instructors could resemble high-fidelity environments via the process of integrating human-patient simulations [28], mannequins [29], or simulation suites [30] to work with one another.…”

“…Airways and diagnosis have created new research revenues in clusters away from their central counterparts, indicating a broader scale of medical simulations. As shown in Figure 6, the citation networks of articles are formed by keywords such as simulation (155), medical education (106), teamwork (52), anaesthesia (28), non-technical skill (26), airway (25), cardiopulmonary resuscitation (21), and diagnosis (2). Remarkably, each network contains publications throughout the course of the time period.…”

Learning to Work Together Through Talk: Continuing Professional Development in Medicine

“…There is an interesting relationship, moreover, between those dialogues and the media through which they take place. Inperson compared with telephone conversations, for example, are differently shaped by their social contexts in ways that are familiar to all physicians but currently ill-understood by researchers (Henn et al, 2012).…”

Experiences of Obstetricians and Gynecologists in Teleconsultation with Medical Residents: A Qualitative Study

“…Medical consultations commonly take place through telephone communications (Haldis & Blankenship, 2002;Henn et al, 2012). Teleconsultation via communicative instruments requires virtual but responsible involvement of the supervising physician (clinical professor) to monitor the clinical decisions made by the regarding medical residents, especially in teaching hospitals.…”