Assessment of email communication skills of rheumatology fellows: a pilot study

Abstract

Physician-patient email communication is gaining popularity. However, a formal assessment of physicians' email communication skills has not been described. We hypothesized that the email communication skills of rheumatology fellows can be measured in an objective structured clinical examination (OSCE) setting using a novel email content analysis instrument which has 18 items. During an OSCE, we asked 50 rheumatology fellows to respond to a simulated patient email. The content of the responses was assessed using our instrument. The majority of rheumatology fellows wrote appropriate responses scoring a mean (±SD) of 10.6 (±2.6) points (maximum score 18), with high inter-rater reliability (0.86). Most fellows were concise (74%) and courteous (68%) but not formal (22%). Ninety-two percent of fellows acknowledged that the patient's condition required urgent medical attention, but only 30% took active measures to contact the patient. No one encrypted their messages. The objective assessment of email communication skills is possible using simulated emails in an OSCE setting. The variable email communication scores and incidental patient safety gaps identified, suggest a need for further training and defined proficiency standards for physicians' email communication skills.

SEND IT: Study of E-Mail Etiquette and Notions from Doctors in Training

“…Most literature discussing the use of e-mail communication in the health care sector deals with guidelines for proper e-mail use between physicians and patients in terms of the utility and appropriateness of such communication. [8][9][10][11][12][13][14][15][16][17][18] The American Medical Association has also developed e-mail communication guidelines for physicians 19 ; similar to the aforementioned literature, these guidelines refer to the appropriate use and security of e-mail as a medium of care delivery, not necessarily specific suggestions for writing e-mail messages with optical characteristics that recipients will tend to favor.…”

Patient-centred care in established rheumatoid arthritis

“…Can you tell me in your own words what you have understood and then, if necessary, I can help clarify An example of integrating the view of the patients with regard to his/her condition is the application of PROs (Patient-Reported Outcomes), with disease-specific instruments as there is the RAID [46] (rheumatoid arthritis impact of disease) or generic instruments such as the short-form (SF)36 [47]. Online communication between patients and professionals is gaining popularity, and it helps to overcome a barrier to be able to reach the specialist at certain times [48].…”

Comparison of E–Mail Communication Skills Among First– and Fourth–Year Dental Students

“…An intern, a fourth–year Health Management Systems student from Rangos School of Health Sciences, Duquesne University, evaluated each de–identified response for the purposes of this research project. We read each individual case and compared it against a rubric adapted and modified from a study by Mittal et al 23 to reflect a dental focus (Appendix B). We collectively discussed discrepancies of responses to achieve agreement.…”

“…Mittal et al have developed a scoring instrument (rubric) to evaluate responses measuring whether 1) fellows understand the provider–patient relationship, 2) they are aware of the administrative, confidentiality, and legal aspects of e–mail communication, and 3) they are able to compose a response in a professional manner. The responses of the fellows showed wide variation, highlighting the need for including didactic modules on e–mail communication in the fellowship program or earlier in medical education 23 …”