Improving Family Medicine Residents’ Written Communication

Abstract

Background: Although competency in written communication is a core skill, written communication is seldom the focus of formal instruction in medical education. The objective of this intervention was to implement a selfassessment strategy to assist learners in improving their letter writing skills and then to evaluate its feasibility, reliability and potential educational value.Methods: Eight first-year family medicine residents from two teaching sites completing a six month family medicine rotation used a self-assessment process which included a self-study module and an assessment tool for letters. Each resident applied the self-assessment tool to eight to ten consecutive consult/referral request letters. Participants submitted initial and redrafted letters for independent rating.Results: Analysis of the content, style and global ratings of the initial 77 draft letters showed multiple deficiencies in the content of their letters. It was confirmed that by using the self-assessment tool, residents were able to reliably assess the quality of their letters. Residents' assessments and those of the expert closely correlated (Pearson correlation 0.861, p < 0.0001). Over the course of the study the residents' overall performance improved and the difference in total scores between the initial drafts and the rewritten letters narrowed. Conclusion:A self-assessment process of written communication significantly improves the quality and completeness of routine consult/referral request letters.

Avaliação das informações contidas nos encaminhamentos dos pacientes da atenção primária do município de Rio do Sul (SC)

“…A pesquisa mostra que os médicos da atenção primária da RAS estudada, na grande maioria das vezes, referenciam seus pacientes com informações de dados demográficos e queixa principal ou motivo da referência. Esses dados expõem o contraste com o estudo desenvolvido no Canadá por François, 11 em que os residentes em Medicina da Família auditaram suas próprias cartas de encaminhamento, e a única variável que não estava presente em 70% dos encaminhamentos, entre aquelas que este trabalho também analisou, era a informação sobre alergias. Essa diferença pode ser justificada pelo fato de os médicos da RAS estudada verem o encaminhamento como um processo necessário para o paciente ser referenciado a um especialista, e não como um meio de comunicação para troca de informações, como os residentes de Medicina da Família canadenses.…”

General practitioners teaching new surgical trainees about clinic letter writing

“…What evidence there is suggests, unsurprisingly, that clinic letter writing is not an innate skill and improves with education. 5,6 What makes a 'good' clinic letter is a topic for debate. Several studies from various specialities have looked at the differing opinions of GPs and patients regarding letter quality.…”

“…7 The participants were encouraged to seek feedback from colleagues, GPs and patients about their letter writing; feedback has been shown to both improve letter quality and be welcomed by trainees. 3,5,7 By the end of the session the participants had considered the letters from three different perspectives and derived by consensus the important features of an effective letter. All groups concluded that they would like to produce three letters.…”

“…There is wide variation in these practices . The participants were encouraged to seek feedback from colleagues, GPs and patients about their letter writing; feedback has been shown to both improve letter quality and be welcomed by trainees …”

“…In preparing this manuscript, no published articles describing how the subject has been taught were found. What evidence there is suggests, unsurprisingly, that clinic letter writing is not an innate skill and improves with education …”