Effectiveness of a Curriculum in Telephone Medicine

Abstract

Background: Telephone medicine is an important but seldom-taught part of generalist physician's practices. Surveyed residents have expressed discomfort with this aspect of ambulatory care. Description: To determine if a telephone-medicine curriculum improves telephone-medicine skills of internal-medicine residents. Evaluation: Residents at West Virginia University (WVU) and the Moses Cone Memorial Hospital (N = 29) tested a telephone-medicine curriculum. They completed pre-and postcurriculum objective structured clinical examinations (OSCEs). Half of the WVU residents underwent the post-OSCE immediately and half after 6 months. All residents completed daily evaluations of the curriculum. Conclusions: The post-OSCE scores improved significantly( ps for each group < .01). Means of daily evaluationswere 4.2± 4.7 (on 1± 5 scales) for curricularcontent and delivery. The residents felt significantlybetter able to manage patients' calls after 2 sessions (p < .01). Improvement was seen in the telephone OSCE and was maintained 6 months later. This curriculum is well received and an effective method for teaching telephone-medicine skills.

“You're Being Paged!” Outcomes of a Nursing Home On‐Call Role‐Playing and Longitudinal Curriculum

“…First, the structured role‐playing didactic session successfully improved self‐assessed attitudes and skills in NH care of different types of learners. Previous studies have examined outcomes of outpatient telephone‐based curricula focusing on the care of home‐bound individuals for internal medicine trainees . Given the importance of telephone communication and management in NH medicine, the lack of previous telephone‐based curricula published for NH medicine reveals a need for greater focus in this area.…”

“…No training is often provided for internal medicine (IM) residents, family medicine (FM) residents, or nurse practitioners (NPs) who may provide NH care after completing clinical training. [2][3][4][5][6][7][8][9][10][11] Studies of outpatient telephone-based curricula have demonstrated improvements in trainee knowledge and abilities, [12][13][14] but to the knowledge of the authors, there are no data on effectiveness of training for the on-call management of NH residents.…”

After‐Hours Calls from Long‐Term Care Facilities in a Geriatric Medicine Training Program

“…Therefore, in addition to condition‐specific educational materials, physician‐trainees may benefit from information specific to effective nurse–physician communication 16 . Previous educational programs to train internal medicine and family practice residents in doctor–patient telephone communication have been shown to reduce negative attitudes toward calls, increase resident confidence in handling calls, and improve scores on an objective structured clinical examination 17,18 . The multiple modalities used in these programs, such as standardized patient scenarios, audio and videotapes, and role play, may prove useful in programs to improve nurse–physician communication as well 17,18 .…”

“…17,18 The multiple modalities used in these programs, such as standardized patient scenarios, audio and videotapes, and role play, may prove useful in programs to improve nurse-physician communication as well. 17,18 Previous studies have documented that nursing home patients generate a disproportionately large number of after-hours calls to office-based practices. 19 Therefore, this type of training could also be valuable to physician-trainees in specialties other than geriatrics.…”

Preventing communication errors in telephone medicine

“…Simulations minimize emotional threats to trainees and serve as a comprehensible and engaging means of addressing systems issues 27 . A curriculum in telephone error prevention could be evaluated using standardized patients in an objective structured clinical examination 28 . For practicing physicians, continuing medical education courses on patient safety might be expanded to include telephone cases such as those presented in this paper.…”