377TF The Patient Experience: Increasing Medical Student Awareness of Patient-Centered Care

Abstract

The doctor-patient relationship is the cornerstone of modern medicine. Medicine continues to evolve from a paternalist model to one focused on patient-centered care. Over the last several years, a patient’s satisfaction with her emergency department stay has gained increased importance. Satisfaction is based on a variety of factors, including interactions with staff and being involved in one’s own care decisions. Increased satisfaction is beneficial to patients, physicians, and institutions; patients are happier about the care they receive, physicians are likely to have a sense of greater job fulfilment (thus reducing burnout), and hospitals will likely get higher reimbursements as patient satisfaction scores now affect compensation. Patient-centered care (PCC) has been linked with increased patient satisfaction, better self-management of chronic conditions, and increased efficiency. Though recognized as an integral part of the doctor/patient relationship, communication, and by extension PCC, is often minimized during the third and fourth year of medical school training. An unofficial survey done with third year medical students participating in our emergency medicine (EM) clerkship showed students felt they received little to no formal training on PCC. Introducing a formalized patient-centered care component into the EM clerkship may benefit students by increasing their awareness of PCC, help them hone their communication skills, and lay the groundwork for a career centered around PCC. Upon completing this curriculum, learners should be able to: 1) define PCC and explain its importance in modern health care; 2) describe different ways they can increase PCC in their future patient interactions; 3) discuss how their views towards PCC have changed since the beginning of this learning module. This course is designed for third year medical students participating in the EM clerkship to help increase their understanding of PCC. The module includes two 60-minute classroom sessions, three different reading assignments, a 15-minute standardized patient (SP) encounter followed by a 15-minute debriefing session with the SP and a mentor, a four-hour patient shadowing shift, a module debriefing session, a PCC pre-test, and a PCC post-test. Student evaluation is done on a pass/fail grading scheme and is based on attendance, active participation, and timely completion of assignments. Learners will fill out a PCC pre-test and post-test; differences between these two will be used to determine if students’ views on PCC changed over the course of the rotation. A debriefing session will occur during the second classroom session; students will have the opportunity to discuss how their views on PCC have changed since starting this curriculum, and how it can be improved for future use. An email with the PCC-post survey will be also be sent to learners one year after the curriculum to determine if this module resulted in sustained attitude changes towards PCC. This module can be used to help fill the gap that currently exists in many medical school education curricula and train providers to focus on PCC.