Interprofessional communication in the emergency department: residents' perceptions and implications for medical education.

Marleen Olde Bekkink,Susan E. Farrell,James Kimo Takayesu

doi:10.5116/ijme.5bb5.c111

Abstract

ObjectivesObjectives of the current study were to: i) assess residents’ perceptions of barriers and enablers of interprofessional (IP) communication based on experiences and observations in their clinical work environments, ii) investigate how residents were trained to work in IP collaborative practice, iii) collect residents’ recommendations for training in IP communication to address current needs. MethodsFocus group study including fourteen Emergency Medicine (EM) residents, who participated in four focus groups, facilitated by an independent moderator. Focus group interviews were audiotaped, transcribed verbatim, independently reviewed by the authors, and coded for emerging themes. ResultsFour themes of barriers and enablers to IP communication were identified: i) the clinical environment (high acuity; rapidly changing health care teams, work overload, electronic communications), ii) interpersonal relationships (hierarchy, (un)familiarity, mutual respect, feeling part of the team), iii) personal factors (fear, self-confidence, uncontrolled personal emotions, conflict management skills), and iv) training (or lack thereof). Residents indicated that IP communication was learned primarily through trial and error and observing other professionals but expressed a preference for formal training in IP communication. ConclusionsBased on this pilot study, barriers to effective IP communication in the ED were inherent in the system and could be exacerbated by relational dynamics and a lack of formal training. Opportunities for both curricular interventions and systems changes were identified and are presented.

Highlights

Interprofessional (IP) communication describes the sharing communication is one of the core competency domains for of information
The clinical environment Time pressure was seen as a significant challenge to IP communication, inherent to the high acuity setting of the emergency department (ED) and the constant high volume of workflow as a result of the rapid patient turnover
This study reveals that multiple barriers to effective IP communication in an academic ED exist in the clinical learning environment

Summary

Introduction

Interprofessional (IP) communication describes the sharing communication is one of the core competency domains for of information (by means of verbal, writing or other me- successful IP collaborative practice.[5] In a high-acuity, acadium) among members of different health professionals to demic emergency department (ED), communication beinfluence patient care positively. This includes communica- tween residents and non-physician staff is crucial for safe and tion that may either be intentional or unintentional. Poor IP collaboration is associated with ineffi- mance and patient safety.[7,8] cient patient care,[1] a higher prevalence of medical errors[2,3]

Objectives

Results

Discussion

Conclusion