Clinical Communication Research Articles

Testing the Feasibility of a Digital Point of Care Solution for the Trusted Near Real-Time Bidirectional Exchange of Novel and Informative Adverse Event Information

AbstractA digital point-of-care solution was implemented to test the feasibility of near-real-time bi-directional communication between pharmacovigilance experts (PVEs) and healthcare professionals (HCPs) for exchanging unique and informative adverse event (AE) information. The solution was implemented in a commercially available electronic health record (EHR) system/platform, no direct contact between PVEs and the HCPs was possible. The Clinical Affairs team of the EHR vendor was used as an intermediary to ensure appropriate information was exchanged while protecting HCP and patient privacy. The study yielded 9 drug-event pairs of interest (AEI), 2 of which were confirmed as AEs by the HCP. On average it took 20.6 h to receive initial AEI information and 58.8 h to receive follow-up information, which represents a 96% reduction in time compared to current methods. Both interactions provided unique data that would not have been collected otherwise leading to the PVE being able to appropriately determine a potential causal association. This study successfully demonstrated the feasibility of using a compliant, bi-directional, digitally enabled clinical communication channel at the point of care to complement existing pharmacovigilance activities.

Clinical practice guidelines for the care of patients with a chronic subdural haematoma: multidisciplinary recommendations from presentation to recovery

Introduction A chronic subdural haematoma (cSDH) is an encapsulated collection of fluid and blood degradation products in the subdural space. It is increasingly common, affecting older people and those living with frailty. Currently, no guidance exists to define optimal care from onset of symptoms through to recovery. This paper presents the first consensus-built recommendations for best practice in the care of cSDH, co-designed to support each stage of the patient pathway. Methods Guideline development was led by a multidisciplinary Steering Committee with representation from diverse clinical groups, professional associations, patients, and carers. Literature searching to identify relevant evidence was guided by core clinical questions formulated through facilitated discussion with specially convened working groups. A modified Delphi exercise was undertaken to build consensus on draft statements for inclusion in the guideline using survey methodology and an in-person meeting. The proposed guideline was subsequently endorsed by the Society for British Neurological Surgeons, Neuroanaesthesia and Critical Care Society, Association of Anaesthetists, British Association of Neuroscience Nurses, British Geriatric Society, and Centre for Perioperative Care. Results We identified that high quality evidence was generally lacking in the literature, although randomised controlled trial (RCT) data were available to inform specific recommendations on aspects of surgical technique and use of corticosteroids. The final guideline represents the outcome of synthesising available evidence, consensus-built expert opinion and patient involvement. The guideline comprises 67 recommendations across eight major themes, covering: presentation and diagnosis, neurosurgical triage and shared decision-making, non-operative management, perioperative management (including anticoagulation), timing of surgery, intraoperative and postoperative care, rehabilitation and recovery. Conclusions We present the first multidisciplinary guideline for the care of patients with cSDH. The recommendations reflect a paradigm shift in the care of cSDH, recognising and formalising the need for multidisciplinary and collaborative clinical management, communication and decision-making delivered effectively across secondary and tertiary care.

Emotional management and clinical communication among nursing students: a single institution experience

BackgroundThe development of emotional and clinical communication is crucial for being a nurse. The aim of this study is to evaluate the influencing factors of emotional management and clinical communication competencies among nursing students, to inform strategies for enhancing the management and nursing care practices.MethodsThis study was a cross-sectional survey. The study period was from December 1 to December 31, 2022, during which nursing students were the population of the survey. The assessments of the emotional management and clinical communication competencies of the nursing students were conducted using the validated Emotion Management Ability Questionnaire and the Clinical Communication Ability Scale, respectively.ResultsA total of 356 nursing students were investigated in this study. The nursing students had moderate ability of emotional management and clinical communication. The emotional management ability was correlated with the clinical communication ability of nursing students (all p<0.05). The results of multivariate regression analysis indicated that gender, educational level and home place were the independent influencing factors on the emotional management ability in the nursing students (all p<0.05). Family structure, internship time and personality were the independent influencing factors for the clinical communication ability among the nursing students (all p<0.05).ConclusionsThe competencies in emotional management and clinical communication among clinical nursing students warrant enhancement. It is imperative to implement tailored educational and training programs to optimize the development and performance of nursing students in their clinical training.

Supporting cancer-related fatigue self-management: A conversation analytic study of nurse counsellor and cancer survivor consultations

PurposeCancer-related fatigue (CRF) is a prevalent and distressing symptom experienced by people affected by cancer. A breakdown of the clinician-patient partnership and suboptimal clinician communication has been identified as a significant barrier to implementing into clinical practice effective self-management strategies for CRF. This study examined the use and impact of communication practices employed by trained cancer nurse counsellors when providing CRF self-management support to cancer survivors. MethodsInteractions from 41 telehealth consultations between three nurse counsellors and 23 cancer survivors in a CRF self-management support clinic in Queensland, Australia were recorded and analysed using conversation analysis methods. ResultsAnalysis found that in instances where nurses established the agenda of a consultation from the outset of a session (e.g., focusing on fatigue self-management support), cancer survivors displayed clearer understandings of their self-management role, the tasks, and goals of a session; and displayed less difficulty engaging in supportive care discussions. Furthermore, clinicians used formulation practices, such as summarising dialogue, to sustain focus on fatigue during consultations, and to close discussion matters not ostensibly pertinent to fatigue self-management planning supporting the goals of the CRF SMS clinic consultations. ConclusionFor supportive care sessions targeting fatigue management, clinicians should ideally focus discussion on CRF support early, by clearly introducing the agenda at the outset of the consultation while also asking for client agreement. Periodically summarising patient's talk allows clinicians to maintain a focus on matters relevant for self-management fatigue planning and provide support within the typically constrained timeframes allocated for addressing CRF.

Promoting Clinical Judgment and Communication Using Student-Led Rounding.

Promoting Clinical Judgment and Communication Using Student-Led Rounding.

Improving psychological and social support needs after traumatic birth: A qualitative study

IntroductionEmergency deliveries increase maternal risk for postpartum depression (PPD) and post-traumatic stress disorder (PTSD). One in three women describe their birth experience as traumatic, but patient-centered support needs are unclear. We conducted a qualitative study of women with traumatic birth to identify patient-centered priorities to optimize mental health support. MethodsSemi-structured interviews were conducted with women who experienced an emergency during birth, and who self-identified as experiencing traumatic birth. The Stanford Acute Stress Reaction Questionnaire and PTSD Checklist were completed. Interviews included open-ended questions about birth events that improved or worsened their delivery experience, perceptions of mental, physical, and emotional support provided by staff, and patient perspectives about psychological and social support referrals after emergent deliveries. ResultsA majority of participants met positive screening criteria for PTSD at the time of interviews. Birth experiences were affected by prenatal expectations, as well as the style and quality of clinical staff communication during and after delivery. There were four key themes central to their experiences and perceptions: (1) Emotional Impact and Intensity, (2) Factors Influencing Birth Experience, (3) Perceived Lack of Emotional Support, and (4) Desire for Post-Birth Follow-Up and Support. Participants almost unanimously desired to be offered psychosocial services after birth trauma. ConclusionThere are significant gaps in emotional support and communication for patients experiencing traumatic births. Offering structured, in-hospital mental health referrals may address immediate psychological needs, aid in trauma recovery, and potentially mitigate long-term mental health consequences. These findings advocate for a more holistic approach to postpartum care that prioritizes both physical and emotional well-being.

Medical Decision-Making and Bereavement Experiences After Cardiac Arrest: Qualitative Insights From Surrogates.

Surrogates of incapacitated patients in the intensive care unit (ICU) face decisions related to life-sustaining treatments. Decisional conflict is understudied. To compare experiences of ICU surrogates by reported level of decisional conflict related to treatment decisions after a patient's cardiac arrest preceding death. Convergent mixed methods were used. Bereaved surrogates recruited from a single northeastern US academic medical center completed surveys including the low-literacy Decisional Conflict Scale (moderate-to-high cut point >25) and individual interviews about 1 month after the patient's death. Interview data were analyzed by directed and conventional content analysis. Surrogates were stratified by median total survey score, and interview findings were compared by decisional conflict level. Of 16 surrogates, 7 reported some decisional conflict (median survey score, 0; range, 0-25). About two-thirds decided to withdraw treatments. Three themes emerged from interviews: 2 reflecting decision-making experiences ("the ultimate act"; "the legacy of clinician communication") and 1 reflecting bereavement experiences ("I wish there was a handbook"). Surrogates reporting decisional conflict included those who first pursued but later withdrew treatments after a patient's in-hospital cardiac arrest. Surrogates with decisional conflict described suboptimal support, poor medical understanding, and lack of clarity about patients' treatment preferences. These findings provide insight into bereaved ICU surrogates' experiences. The low overall survey scores may reflect retrospective measurement. Surrogates who pursued treatment were underrepresented. Novel approaches to support bereaved surrogates are warranted.

Barriers to Serious Illness Conversations Among Patients with Advanced Cancer: A Qualitative Study

Serious illness conversations (SICs) are discussions between clinicians and cancer patients about illness understanding, information preferences, and goals of care. Interventions to prompt SICs increase SIC rates and improve care delivery near the end of life. This embedded sub-study examined SIC barriers and facilitators among "refractory" patients without an SIC despite enrollment in an SIC clinical trial. We recruited advanced cancer patients with no documented SIC 60 days after randomization in a clinical trial of patient- and clinician-nudges to engage in SICs. We conducted semi-structured interviews with patients and their caregivers if present and brief email surveys with patients' oncologists. We used qualitative content analysis to identify themes related to SIC barriers and facilitators and to identify strategies to improve SICs. Of 44 participants, 19 were patients, 10 were caregivers, and 15 were oncologists. Themes of SIC barriers and facilitators included (1) how patients coped with their illness, which shaped their readiness for SICs; (2) clinician communication style, which shaped ease of having an SIC; (3) prognostic uncertainty and disease stability, which could prompt or justify delaying an SIC; and (4) family members' presence, which could instigate an SIC. Regarding ways to improve SIC nudges, patients and caregivers had mixed perspectives but often highlighted a preference for interventions with personal touches. Patient readiness remains an important barrier even after targeted SIC interventions. Future SIC interventions should consider approaches tailored to patient communication preferences and interventions involving personal interactions.

Quality of life, anxiety and mindfulness during the prevalence of COVID-19: a comparison between medical and non-medical students

BackgroundThe Covid-19 pandemic has affected all areas of society, including students. However, medical students have faced many challenges due to direct contact with patients. The present study was conducted with the aim of investigating and comparing the quality of life (QoL), anxiety and mindfulness between Iranian medical and non-medical students during the COVID-19 pandemic.MethodFive hundred and six students (both medical and non-medical students) participated in the study from August to October 2022 with a convenience sampling method. The data were collected using an online questionnaire including a demographic form, the QoL Questionnaire (WHOQOL- BREF), the Generalized Anxiety Disorder 7-item survey (GAD‐7) and the Relaxation/Meditation/Mindfulness Tracker t-Persian version survey (RMMt-P). Pearson correlation and independent t-test and multivariate linear regression were used to determine the relationship between the study variables.ResultsThe samples included 272 medical students and 234 non-medical students with a mean age of 21.99 ± 3.46 and 24.17 ± 6.54 years respectively. Most of the medical and non-medical students were female, single and had a bachelor’s degree. The mean scores of medical and non-medical students’ QoL during the COVID-19 pandemic were 57.86 ± 13.26 and 56.75 ± 14.42, respectively which indicates the higher quality of life of medical students. Anxiety and mindfulness predicted 29% of the variance of the QoL in the medical students, while anxiety and mindfulness and having a chronic disease predicted 30% of the variance of the QoL in the non-medical students. No significant difference existed in the QoL and its subscales during the COVID-19 pandemic between medical and non-medical students (p > 0.05). There was a significant difference in terms of anxiety (p = 0.02) and mindfulness (p = 0.03) between medical and non-medical students during the prevalence of COVID-19.Discussion and conclusionThe findings of the present study indicated that medical students exhibited lower levels of anxiety and higher levels of mindfulness. Therefore, interventions aimed at reducing anxiety and increasing mindfulness among non-medical students are necessary. It is recommended that preventive approaches and psychological interventions to improve students’ quality of life become an integral part of crisis response during the COVID-19 pandemic. Additionally, reducing anxiety and enhancing mindfulness can improve the quality of education and professional performance of medical students, while also contributing to their mental well-being and effective clinical communication.

Balancing Objective Markers and Subjective Experience in Eating Disorder Diagnoses: Commentary on Dang et al. (2024).

The results of Dang et al.'s recent systematic review and meta-analysis suggested that individuals diagnosed with other specified feeding or eating disorder (OSFED) and those diagnosed with specified eating disorders (EDs, such as bulimia nervosa) endorse similar, elevated levels of ED-related cognitions (but not behaviors). The DSM has traditionally conceptualized EDs primarily as disturbances in eating behavior, and the diagnostic boundaries for EDs are based on objective markers, such as behavioral frequencies and weight. Although focusing on objective markers for ED diagnoses and severity indices has advantages (e.g., clinical communication, measurement), pitfalls include diagnostic migration and low emphasis on ED cognitions. Dang et al.'s findings provide a basis for rethinking DSM's conceptualization of EDs as primarily behavioral. This commentary discusses the potential merits and challenges of emphasizing subjective cognitions when assigning ED diagnoses. We explore how objective markers (e.g., behavioral frequency, weight) and subjective experience (e.g., fear of weight gain) may be balanced to improve the clinical utility of ED diagnoses. In all, research that more deeply phenotypes the subjective experiences of people with EDs across contexts, identities, and cultures will enrich our understanding of eating pathology and may inform diagnostic revisions.

Expanding the primary care workforce by integrating genetic counselors in multidisciplinary care teams.

Collectively, rare diseases are common, affecting approximately 8% of the population in Canada and the USA. Therefore, the majority of primary care (PC) clinicians will care for patients who are affected or at risk for a genetic disease. Considering the increasing ways in which genetics is being implemented into all areas of healthcare, one way to address these needs and expand the capacity of the PC workforce is through the integration of genetic counselors (GCs) into PC multidisciplinary teams. GCs are Masters-educated allied health professionals with specialized training in molecular genetics, communication, and short-term psychotherapeutic counseling. The current models of GCs in PC mimic other multidisciplinary models. Complex tasks related to genetics, such as pre- and post-test counseling, genetic test selection, and results interpretation, are conducted by GCs, which, in turn, allows physicians, nurse practitioners, and other PC providers to work at the top of their scope of practice. Quality genetics services provided by GCs improve clinical outcomes for patients and their families; the simultaneous provision of genetic education and psychological support by a GC is associated with an increase in patient knowledge, perceived personal control, decrease in distress, and can lead to positive health behavior changes, all of which are aligned with the goals of primary healthcare. With their extensive training in clinical care, medical communication, and psychotherapeutic counseling, integrating GCs into PC care teams will improve the care patients receive and allow PC clinicians to ensure their patients are at the forefront of the personalized medicine revolution.

Impact of teaching modality on soft skill development: Oral health literacy awareness skills assessed using standardized patient experiences.

Health literacy awareness is a crucial skill for health professionals, yet training may be lacking. Didactic lectures may improve health literacy awareness in future health professionals, however, compressed curricula may lead educators to consider the incorporation of eLearning into the delivery of health literacy education. E-modules have been shown to engage learners, yet little is known about their effectiveness in instilling behavioral change in learners' clinical communication skills. This study aimed to shed light on the impact of learning modality on dental students' ability to learn and translate soft skills into clinical settings. An e-module on health literacy awareness was created by the researchers with an equivalent lecture developed. Fifty-six dental students were randomly assigned to a control or intervention cohort (lecture or e-module) and all cohorts participated in standardized patient experiences to be assessed in a simulated but authentic patient care scenario. Pre- and post-intervention scores, simulation scores, and learner reflections were compared. Fifty-six students participated in the study. Post-intervention health literacy awareness knowledge increased for both intervention cohorts. In clinical simulation, intervention cohorts scored significantly higher on nearly all variables, with the lecture cohort scoring consistently better than e-learners. Both lecture and e-learning are effective learning modalities for promoting health literacy awareness, but dental students learning the subject via lecture may translate certain newly acquired soft skills more effectively in clinical scenarios.

Perceived effectiveness of the person–environment–occupation innovative teaching model in rehabilitation therapy students

BackgroundGiven the characteristics of the rehabilitation therapy specialty and the drawback of the traditional didactic teaching approach, we developed the innovative teaching approach from the students’ perspective using the person–environment–occupation (PEO) model. The new model was developed from the original PEO model to be applied in pedagogical contexts and tailored to the characteristics of an application-oriented specialty, such as rehabilitation therapy. The present study aimed to examine the perceived effectiveness of the PEO innovative teaching model applied to rehabilitation therapy students.MethodsA pre–post descriptive study was conducted to compare the perceived effectiveness of the PEO innovative teaching model for two consecutive student cohorts. A purposive sampling method was used to recruit students from two cohorts of junior medical students majoring in rehabilitation therapy in the spring semesters of 2020 and 2021. A questionnaire was developed to evaluate the perceived effectiveness of the PEO innovative teaching model. SPSS version 26.0 was used to perform data analysis.ResultsA total of 112 students were included in the study and completed both pre- and post-tests. Of 112 received questionnaires, 101 were considered as valid questionnaires after the quality check (effective rate 90.18%). In the 2020 and 2021 cohorts, students rated the PEO innovative teaching model significantly higher than the didactic teaching approach in the following aspects: the teaching content is highly professional and valuable; the course is extensively expounded; the clinical reasoning is strengthened; problem-solving ability is developed; communication skills are improved; and teamwork skills are developed.ConclusionThe PEO innovative teaching model was perceived to be an effective teaching strategy to enhance students’ academic performance. In addition, three core skills including clinical reasoning, problem-solving ability, and communication skills were improved by the PEO innovative teaching model.

Automatic Enrollment in Patient Portal Systems Mitigates the Digital Divide in Healthcare: An Interrupted Time Series Analysis of an Autoenrollment Workflow Intervention

PurposeRacial and ethnic healthcare disparities require innovative solutions. Patient portals enable online access to health records and clinician communication and are associated with improved health outcomes. Nevertheless, a digital divide in access to such portals persist, especially among people of minoritized race and non-English-speakers. This study assesses the impact of automatic enrollment (autoenrollment) on patient portal activation rates among adult patients at the University of California, San Francisco (UCSF), with a focus on disparities by race, ethnicity, and primary language.Materials and methodsStarting March 2020, autoenrollment offers for patient portals were sent to UCSF adult patients aged 18 or older via text message. Analysis considered patient portal activation before and after the intervention, examining variations by race, ethnicity, and primary language. Descriptive statistics and an interrupted time series analysis were used to assess the intervention’s impact.ResultsAutoenrollment increased patient portal activation rates among all adult patients and patients of minoritized races saw greater increases in activation rates than White patients. While initially not statistically significant, by the end of the surveillance period, we observed statistically significant increases in activation rates in Latinx (3.5-fold, p = < 0.001), Black (3.2-fold, p = 0.003), and Asian (3.1-fold, p = 0.002) patient populations when compared with White patients. Increased activation rates over time in patients with a preferred language other than English (13-fold) were also statistically significant (p = < 0.001) when compared with the increase in English preferred language patients.ConclusionAn organization-based workflow intervention that provided autoenrollment in patient portals via text message was associated with statistically significant mitigation of racial, ethnic, and language-based disparities in patient portal activation rates. Although promising, the autoenrollment intervention did not eliminate disparities in portal enrollment. More work must be done to close the digital divide in access to healthcare technology.

Patient's Perspective on Miniscrews During Orthodontic Treatment-A Systematic Review With Meta-Analysis.

During orthodontic treatment, undesirable reciprocal forces are generated during tooth movement, which explains the use of anchorage strategies to minimise their harmful effects through intra and/or extraoral appliances. Miniscrews are intraoral devices used for temporary skeletal anchorage. Miniscrews are small-sized intraoral devices used for temporary skeletal anchorage and are easy to place and remove. However, some studies refer to adverse effects such as inflammation, pain, and discomfort. This systematic review aims to synthesise the available evidence on the use of miniscrews during orthodontic treatment from the patient's perspective. The literature search was conducted using various databases MedLine through PubMed, Cochrane Library, Web of Science Core Collection, and EMBASE. A search was also carried out in the grey literature. The search terms used were "Orthodontic Anchorage Procedures," "mini-implant," "Mini Dental Implant," "Miniscrew," and "microimplant." Cochrane risk of bias tools was used to assess the quality of included studies. Patients tend to overestimate the pain inherent in this procedure. The insertion of micro implants is more accepted than the tooth extraction procedure, with less postoperative pain reported. The location, surgical technique, and type of anaesthesia used in the placement of miniscrews influence levels of discomfort. Additionally, the execution of a good surgical technique and the clinician's communication skills are factors that influence patient satisfaction and positive perception. The most frequent outcome reported is pain and discomfort, which varies depending on its location (less with mini interradicular screws than with extra-alveolar screws). Most patients are satisfied or very satisfied with this application.

Crafting the Future of Community-Based Medical Rehabilitation: Exploring Optimal Models for Non-Inpatient Rehabilitation Services through a Narrative Review.

Community-based medical rehabilitation encompasses diverse programs that cater to patients outside of inpatient settings, such as home rehabilitation, day rehabilitation centers, and ambulatory clinics. While inpatient rehabilitation principles are widely standardized, outpatient programs display significant variability influenced by healthcare models, local environments, economic constraints, and available resources. This narrative review aims to explore and synthesize the various models of non-inpatient rehabilitation services, evaluating their effectiveness, cost-efficiency, and patient satisfaction. The review also seeks to identify optimal practices and strategies to enhance community-based rehabilitation, alleviate the burden on inpatient facilities, and improve patient outcomes through multidisciplinary and patient-centered approaches. Additionally, the study examines the critical role of a professional program coordinator and the importance of effective clinical communication in outpatient rehabilitation. A comprehensive search of peer-reviewed literature was conducted across multiple databases, focusing on studies that examined community-based rehabilitation models. The findings suggest that community-based rehabilitation programs are generally more cost-effective than inpatient programs, with their success being heavily dependent on the intensity and timing of interventions. Multidisciplinary approaches and high-intensity rehabilitation have shown promise in improving patient quality of life, though their effectiveness varies by condition. Despite limited research, the involvement of a Physical and Rehabilitation Medicine (PRM) physician as a program coordinator appears vital for ensuring continuity of care. Moreover, effective clinical communication is essential, impacting all aspects of patient care and interprofessional collaboration, with continuous adaptation required to meet the evolving needs of diverse patient populations.

Translating Evidence to Practice in Clinical Communication Safety.

Translating Evidence to Practice in Clinical Communication Safety.

Effective Clinical Externships for International Medical Students: A Qualitative Study.

International student exchanges are a significant part of medical education, and experiences of North American and European medical students abroad have been extensively examined. By contrast, knowledge of visiting medical students in the United States (US) is limited largely to surveys of administrators and course directors. To understand US attending physicians' thoughts on visiting international student clinical externships. Three clinician-educator physician focus groups were conducted across two US medical schools with broad representation of training backgrounds, clinical disciplines, and career stages. Focus groups and constant comparison analysis of transcripts were performed iteratively to identify emerging themes. Qualitative themes and subthemes. Two main themes emerged from the data: (1) administrative requirements for success: hosting international students requires careful planning and coordination, which is daunting amidst demanding faculty responsibilities. Externships must address experiences of the people directly involved in the clinical setting, leadership, communication, and institutional, financial, physical, and personnel resources. (2) Impact of student qualities: When working with international students, the importance of administrative details and student characteristics increases due to higher student variability overall, inconsistent language and cultural fluency, and the consequent recognition of the student as an ambassador for their home institution and country. Amidst already busy schedules, clinician educators identify the hosting of international medical students as a commitment resembling that for their own trainees. Linguistic and cultural distances, and the overall variability of international students amplify the importance of effective administration. The findings have influenced related processes at the University of Pittsburgh.

Academic hospitalist perspectives on the benefits and challenges of secure messaging: A mixed methods analysis.

Hospitals and patients rely on effective clinician communication. Asynchronous electronic secure messaging (SM) systems are a common way for hospitalists to communicate, but few studies have evaluated how hospitalists are navigating the adoption of SM and the benefits and challenges they are encountering. The objective of this study is to assess academic hospitalist perspectives on SM to guide future research and quality improvement initiatives. This was a mixed methods study utilizing an embedded REDCap survey and six virtual semistructured focus groups. It took place during a Hospital Medicine ReEngineering Network Zoom meeting on October 13, 2023. Rapid qualitative methods were used to define major themes. There were 28 hospitalists and one patient representative across 24 separate academic institutions. There was a 71% survey completion rate (N = 20). SM was felt to be an effective and efficient communication modality but was associated with a large amount of multitasking and interruptions. Perspectives around SM clustered around three main themes: SM has been widely but variably adopted; there is a lack of institutional guidance about how to best engage with SM; and SM is changing the landscape of hospitalist work by increasing ease but decreasing depth of communication, increasing cognitive load, and changing interpersonal relationships. Recommendations for SM improvements included the need for institutions to work with frontline workers to develop and implement clear usage guidelines. SM is likely contributing to both positive and negative effects for clinicians and patients. Understanding hospitalist perspectives on SM will help guide future research and quality improvement initiatives.

Patient safety education in Umm Al-Qura dental school: A comprehensive analysis of curriculum content and student confidence

BackgroundPatient safety (PS) is a critical component in dental education, yet it is not clear how dental schools include PS education in their curricula. AimTo assess how PS topics are presented in the current Umm Al-Qura undergraduate dental (UQUDENT) curriculum and to investigate the self-perceptions of dental students regarding the PS confidence they have attained from their dental program. MethodThe UQUDENT curriculum was mapped using keywords developed from the WHO PS manual. Courses contained intended learning outcomes (ILOs), and lecture topics were identified and ranked based on the level of PS content. In addition, dental students and interns were asked to fill in a modified version of the Health Professional Education in Patient Safety Survey. ResultsA total of 73.2% of the courses included ILOs or topics related to PS. Keywords related to the teamwork topic were the most common (60.9%), followed by patient engagement (24.3%), medication safety (12.2%), and infection control (9.8%). None of the courses included items on overall PS concepts, understanding systems, or quality improvement in relation to PS.Dental students were most confident in their learning regarding clinical safety and effective communication. They were least confident in what they learned about teamwork with other health professionals. There were no statistically significant differences in PS domain scores between classroom and clinical learning. ConclusionThe UQUDENT curriculum covers many aspects of PS. However, the PS content should be explicitly taught and assessed. Areas such as interprofessional education, clinical risk management, learning from errors, and teamwork should be augmented.