Medical Communication Research Articles

Development of a Scoring Rubric Assessing Medical Students' Explanations of Pathology Reports.

With increasing availability of immediate patient access to pathology reports, it is imperative that all physicians be equipped to discuss pathology reports with their patients. No validated measures exist to assess how pathology report findings are communicated during patient encounters. To pilot a scoring rubric evaluating medical students' communication of pathology reports to standardized patients. The rubric was iteratively developed using the Pathology Competencies for Medical Education and Accreditation Council for Graduate Medical Education pathology residency milestones. After a brief training, third- and fourth-year medical students completed 2 standardized patient encounters, presenting simulated benign and malignant pathology reports. Encounters were video recorded and scored by 2 pathologists to calculate overall and item-specific interrater reliability. All students recognized the need for pathology report teaching, which was lacking in their medical curriculum. Interrater agreement was high for malignant report scores (intraclass correlation coefficient, 0.65) but negligible for benign reports (intraclass correlation coefficient, 0). On malignant reports, most items demonstrated good interrater agreement, except for discussing the block (cassette) summary, explaining the purpose of the pathology report, and acknowledging uncertainty. Participating students (N = 9) felt the training was valuable given their limited prior exposure to pathology reports. This pilot study demonstrates the feasibility of using a structured rubric to assess the communication of pathology reports to patients. Our findings also provide a scalable example of training on pathology report communication, which can be incorporated in the undergraduate medical curriculum to equip more physicians to facilitate patients' understanding of their pathology reports.

Rescue Relief Agency Management For Disaster Recovery

In the aftermath of a natural or man-made disaster, the swift and coordinated deployment of rescue agencies is critical to minimizing casualties and maximizing the effectiveness of relief efforts. However, the current landscape of disaster response is often hampered by the absence of a centralized platform for communication and collaboration among various rescue agencies. This lack of a unified system often leads to duplication of efforts, inefficient resource allocation, and delays in providing aid to those in dire need. To address these challenges and enhance the efficiency of disaster response, we propose the development of a comprehensive mobile application that would enable rescue agencies to seamlessly register their information, share real-time location updates, and coordinate their operations effectively. This proposed mobile application would serve as a central hub for rescue agencies to register their information, including their location, contact details, areas of expertise, and available resources. This information could be entered manually or automated using GPS or other location tracking technologies. Once the database is populated, the application would provide a user-friendly interface that allows users to visualize the locations of registered rescue agencies on a map. Additionally, users could filter the results based on specific criteria, such as the type of disaster, the resources available, or the time since the last reported activity. Beyond displaying the locations of rescue agencies, the application would also facilitate communication and collaboration among these organizations. Rescue agencies could send alerts or requests for assistance directly through the application, enabling them to coordinate their efforts and optimize resource utilization. Moreover, the application could facilitate the sharing of critical resources such as medical equipment, transportation, and communication infrastructure, ensuring that these resources are deployed where they are most needed. Overall, the proposed mobile application has the potential to revolutionize disaster response by providing a centralized platform for communication, collaboration, and resource management among rescue agencies. By enabling real-time coordination and efficient resource allocation, this application could significantly enhance the effectiveness of disaster relief efforts, saving lives and minimizing the impact of natural and man-made disasters..

How Chronic Pain Patients’ and Physicians’ Communication Influences Patients’ Uncertainty: A Pre- and Post-Consultation Study

Chronic pain is a health problem that is difficult to diagnose, treat, and manage, partly owing to uncertainty surrounding ambiguous causes, few treatment options, and frequent misunderstandings in clinical encounters. Pairing uncertainty management theory with medical communication competence, we predicted that both physicians and patients are influential to patients’ uncertainty appraisals and uncertainty management. We collected pre- and post-consultation data from 200 patients with chronic neck and spine/back pain and their physicians. Patients’ reports of their physician’s communication were a consistent predictor of their post-consultation uncertainty outcomes. Physicians’ reports of both their own and patients’ communication competence were associated with patients’ positive uncertainty appraisals. Physicians’ reports of patients’ communication competence were also associated with reductions in patients’ uncertainty. Findings illustrate how both interactants’ perceptions of communication competence—how they view their own (for physicians) and the other’s—are associated with patients’ post-consultation outcomes.

How adult children experience and cope with their parents’ diagnosis of multiple myeloma: A qualitative exploration

PurposeThe aim of this study was to understand and explore the caregiving experience of adult children of patients with multiple myeloma (MM) during diagnosis and initial treatment based in Chinese filial piety culture. MethodsA descriptive phenomenology study was conducted to investigate semi-structured interview responses from the adult children (N = 22) of MM patients within three months after diagnosis. Colaizzi's descriptive analysis framework was employed to analyze data. This study was reported following the COREQ checklist. ResultsFour themes and twelve subthemes were identified from the interviews. (1) Commitment to filial piety. Participants subconsciously fulfilled their commitment to filial piety by supporting their parents, obeying their wishes, providing emotional comfort, and protecting them from harm. (2) Experiencing multiple dilemmas. They faced challenges such as difficult treatment decisions, insufficient caregiving preparation, emotional distress, and role conflict. (3) Benefiting from setbacks. The caregiving experience allowed participants to cherish the present more and to establish a new view of life. (4) Adaptive coping. Family supports and self-adaptation are effective coping strategies to achieve their good psychosocial adaptation. ConclusionsOur study provides a culturally sensitive perspective on the caregiving experience of adult children of patients with MM. This study found that Chinese culture, especially filial piety culture, influenced the experiences and coping strategies of MM caregivers. Healthcare providers should focus on the challenges faced by adult children and develop various strategies to help them cushion the burden and adjust to caregiving roles, such as supportive care programs, meaning-centered psychotherapy, and family-centered medical communication interventions.

When do medical operators choose to use, or not use, video in emergency calls? A case study

BackgroundAn evaluation report for a pilot project on the use of video in medical emergency calls between the caller and medical operator indicates that video is only used in 4%...

Risk Factors Associated With Being Lost to Follow-up Among Patients With Pregnancy of Unknown Location [ID 2683399

INTRODUCTION: Managing pregnancy of unknown location (PUL) is a logistical challenge for obstetrician–gynecologists. Close follow-up is a key component of management to reduce the risk of a ruptured ectopic pregnancy. We examined factors that may put patients at increased risk of being lost to follow-up. METHODS: We performed a case–control study of patients presenting to our emergency room with a positive pregnancy test and without previously confirmed intrauterine pregnancy in the first trimester between January 2020 and December 2022. Patients with newly diagnosed PUL were added to a secure list for follow-up (“beta book”). We compared patients who were lost to follow-up, which was defined as after three failed attempts at contact made multiple days apart, with those who were not. Chi-square and Fisher exact assessed demographic exposures putting patients at risk of being lost to follow-up. RESULTS: One hundred nineteen patients had PUL and were added to the beta book. Overall, 15 (12.6%) of patients were lost to follow-up (cases) compared to 104 (87.4%) of patients who were not (controls). No associations were found between sociodemographic variables and risk of being lost to follow-up, including age (P=.15), parity (P=.59), insurance type (P=.81), primary language (P=.77), race (P=.26), and ethnicity (P=.80). Finally, lost to follow-up rates were similar among women enrolled and not enrolled in the institution’s app-based medical communication system (P=.75). CONCLUSION: In a state in which pregnancy-related care is available regardless of immigration status, we found no demographic associations with risk of being lost to follow-up. As 12% of people in this study were still lost to follow-up, qualitative interviews may be useful to better understand factors not captured in a retrospective chart review to improve safe and equitable care.

Evaluating implementation of a community-focused patient navigation intervention at an NCI-designated cancer center using RE-AIM

BackgroundPatient navigation is an evidence-based intervention that reduces cancer health disparities by directly addressing the barriers to care for underserved patients with cancer. Variability in design and integration of patient navigation programs within cancer care settings has limited this intervention’s utility. The implementation science evaluation framework, RE-AIM, allows quantitative and qualitative examination of effective implementation of patient navigation programs into cancer care settings.MethodsThe Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework was used to evaluate implementation of a community-focused patient navigation intervention at an NCI-designated cancer center between June 2018 and October 2021. Using a 3-month longitudinal, non-comparative measurement period, univariate and bivariate analyses were conducted to examine associations between participant-level demographics and primary (i.e., barrier reduction) and secondary (i.e., patient-reported outcomes) effectiveness outcomes. Mixed methods analyses were used to examine adoption and delivery of the intervention into the cancer center setting. Process-level analyses were used to evaluate maintenance of the intervention.ResultsParticipants (n = 311) represented a largely underserved population, as defined by the National Cancer Institute, with the majority identifying as Hispanic/Latino, having a household income of $35,000 or less, and being enrolled in Medicaid. Participants were diagnosed with a variety of cancer types and most had advanced staged cancers. Pre-post-intervention analyses indicated significant reduction from pre-intervention assessments in the average number of reported barriers, F(1, 207) = 117.62, p < .001, as well as significant increases in patient-reported physical health, t(205) = − 6.004, p < .001, mental health, t(205) = − 3.810, p < .001, self-efficacy, t(205) = − 5.321, p < .001, and satisfaction with medical team communication, t(206) = − 2.03, p = .029. Referral patterns and qualitative data supported increased adoption and integration of the intervention into the target setting, and consistent intervention delivery metrics suggested high fidelity to intervention delivery over time. Process-level data outlined a successful transition from a grant-funded community-focused patient navigation intervention to an institution-funded program.ConclusionsThis study utilized the implementation science evaluation framework, RE-AIM, to evaluate implementation of a community-focused patient navigation program. Our analyses indicate successful implementation within a cancer care setting and provide a potential guide for other oncology settings who may be interested in implementing community-focused patient navigation programs.

Legal Protection for Tumor Surgeons on the Side Effects in Breast Cancer Chemotherapy Services

Legal protection for tumor surgeons in facing chemotherapy side effects in breast cancer patients is essential in contemporary medical practice. This study employed a narrative method and legal approach to explore the legal protection available to tumor surgeons in addressing risks and side effects during chemotherapy services. The narrative method was used to explore the role of the law in protecting tumor surgeons and providing a clear framework for addressing side effects in chemotherapy services. Literature analysis regarding medical practice standards, professional responsibilities, and relevant legal cases were used to formulate a comprehensive perspective of this legal protection. The research highlights the need for meticulous documentation of procedures, risks, and patient consent before undergoing chemotherapy. Additionally, legal protection also depends on adherence to applicable medical practice standards and effective communication between tumor surgeons and patients. In conclusion, the understanding of tumor surgeons is needed for the legal implications of their medical practices, including in the context of chemotherapy services. Thus, the use of narrative methods in this study provides valuable insights for tumor surgeons to protect themselves and provide safe and quality services to breast cancer patients.

The 7 Elements Communication Rating Form for Teaching and Assessing Medical Communication Competency.

Medical communication skills are a critical component of clinical medicine and patient satisfaction.Communication skills are difficult to teach and evaluate, necessitating tools that are effective and efficient. This study presents and validates the 7 Elements Communication Rating Form (7E-CRF), a streamlined, dual-purpose, evidence-based medical communication checklist that functions as a teaching and assessment tool. A 14-item teaching and assessment tool is described and validated using face, concurrent, and predictive validity indices.The study was conducted with 661 medical students from the West Virginia School of Osteopathic Medicine (WVSOM).Student performance was assessed in year 1 labs, year 2 labs, and year 2 and year 3 objective structured clinical examination (OSCE).These internal indices were compared with student performance on the Humanistic Domain of the Comprehensive Osteopathic Medical Licensing Examination (COMLEX) Level 2-Performance Evaluation (PE), a licensure exam previously taken in years 3 or 4 of osteopathic medical schools. The evidence of interrater reliability and predictive validity is strong. Data from the 7E-CRF is compared to performance on the COMLEX Level 2-PE, Humanistic Domain. The 7E-CRF can identify students who are at a 10-fold increased risk of failure on the COMLEX Level 2-PE Humanistic Domain. Conclusions:The 7E-CRF integrates instruction and assessment, based on a national and international model. The simplicity, foundation in professional consensus, ease of use, and predictive efficacy make the 7E-CRF a highly valuable instrument for medical schools in teaching and evaluating competency in medical communication skills.

Graduate medical education success coaching for residents and fellows: a single-institution real-world experience

ABSTRACT While coaching has been employed as a success strategy in many areas such as athletics and business for decades, its use is relatively new in the medical field despite evidence of its benefits. Implementation and engagement regarding coaching in graduate medical education (GME) for residents and fellows is particularly scarce. We report our three-year experience of a GME success coaching program that aims to help trainees reach their full potential by addressing various areas of medical knowledge, clinical skills, efficiency, interpersonal skills and communication, professionalism, and mental health and well-being. The majority of participants (87%) were identified by themselves, their program director, and/or the GME coaches to have more than one area of need. The majority (79%) of referrals were identified by the coaches to have additional needs to the reasons for referral. We provide a framework for implementation of a GME coaching program and propose that coaching in GME may provide an additional safe environment for learners to reveal areas of concerns or difficulty that otherwise would not be disclosed and/or addressed.

Intrinsically Stretchable Organic Photodiodes for Faint Near‐Infrared Light Detection and Extendable Cryptographic Imaging

AbstractSkin‐like optoelectronic devices have progressed in leaps and bounds, permitting considerable applications such as remote medical diagnosis, optical communication, biometric authentication, and 3D vision imaging. However, achieving extendable imaging in such frontier detectors poses a formidable challenge for stretchable electronic materials and remains largely unexplored. Herein, an ultrasensitive intrinsically stretchable organic photodiode is configured by the spatially modularizable‐assembled elastic photoactive film for faint near‐infrared light detection and extendable imaging. The performance metrics of the stretchable organic photodiodes rival that of commercial photodetectors, including high specific detectivity (D*noise) over 1012 Jones at 850 nm, ultralow noise current of 4.1 × 10−15 A Hz−1/2 and high stretchability up to 100%. Furthermore, it is the first time to simultaneously achieve the extendable near‐infrared cryptographic imaging and stable photoplethysmography signal detection based on stretchable photodiodes. These results signify a significant advancement toward enabling practical scenarios for stretchable organic optoelectronics.

Assessment of Quality of Life for Elderly Residents: A Cross Sectional Study in Nursing Home Settings

Objective. We aim to assess the quality of life of older individuals living in nursing homes. Methodology. A descriptive cross-sectional study was conducted on institutionalized elderly individuals for over three months. The sample size of the study was 260 and Non-randomized convenience sampling was used. The study excluded participants with cognitive impairment, severe medical conditions, physical limitations, communication barriers, severe pain, recent surgery, acute illness, or psychiatric disorders. Ethical approval was obtained, and participants were given informed consent. The study took place in various nursing homes in Lahore in June and July 2023, for the analysis of data Statistical Package for Social Sciences (SPSS version 22) was used, employing frequency distribution, mean, standard deviation, and correlation. Results. The Pearson Correlation coefficient of 0.459 suggests a significant positive correlation between these variables (p &lt; 0.01). This correlation is evident in both directions: Quality of life (QoL) score to Mini Mental Scale and vice versa. Conclusion. While assessing the QoL in elderly inhabitants of nursing residences, cognitive impairment, and high Body mass index (BMI) appeared to influence the overall QoL.

Beyond words: analyzing non-verbal communication techniques in a medical communication skills course via synchronous online platform.

Effective doctor-patient relationships hinge on robust communication skills, with non-verbal communication techniques (NVC) often overlooked, particularly in online synchronous interactions. This study delves into the exploration of NVC types during online feedback sessions for communication skill activities in a medical education module. A cohort of 100 first-year medical students and 10 lecturers at the Faculty of Medicine, Universiti Kebangsaan Malaysia (UKM), engaged in communication skills activities via Microsoft Teams. Sessions were recorded, and lecturer NVC, encompassing body position, facial expressions, voice intonation, body movements, eye contact, and paralinguistics, were meticulously observed. Following these sessions, students provided reflective writings highlighting their perceptions of the feedback, specifically focusing on observed NVC. The study identified consistent non-verbal communication patterns during feedback sessions. Lecturers predominantly leaned forward and toward the camera, maintained direct eye contact, and exhibited dynamic voice intonation. They frequently engaged in tactile gestures and paused to formulate thoughts, often accompanied by filler sounds like "um" and "okay." This consistency suggests proficient use of NVC in providing synchronous online feedback. Less observed NVC included body touching and certain paralinguistic cues like long sighs. Initial student apprehension, rooted in feelings of poor performance during activities, transformed positively upon observing the lecturer's facial expressions and cheerful intonation. This transformation fostered an open reception of feedback, motivating students to address communication skill deficiencies. Additionally, students expressed a preference for comfortable learning environments to alleviate uncertainties during feedback reception. Potential contrivances in non-verbal communication (NVC) due to lecturer awareness of being recorded, a small sample size of 10 lecturers limiting generalizability, a focus solely on preclinical lecturers, and the need for future research to address these constraints and explore diverse educational contexts. Medical schools globally should prioritize integrating NVC training into their curricula to equip students with essential communication skills for diverse healthcare settings. The study's findings serve as a valuable reference for lecturers, emphasizing the importance of employing effective NVC during online feedback sessions. This is crucial as NVC, though occurring online synchronously, remains pivotal in conveying nuanced information. Additionally, educators require ongoing professional development to enhance proficiency in utilizing NVC techniques in virtual learning environments. Potential research directions stemming from the study's findings include longitudinal investigations into the evolution of NVC patterns, comparative analyses across disciplines, cross-cultural examinations, interventions to improve NVC skills, exploration of technology's role in NVC enhancement, qualitative studies on student perceptions, and interdisciplinary collaborations to deepen understanding of NVC in virtual learning environments.

Do emergency medical dispatchers choose the same response to serious injury in men and women – a qualitative study

BackgroundRecent research has indicated that sex is an important determinant of emergency medical response in patients with possible serious injuries. Men were found to receive more advanced prehospital treatment and more helicopter transportation and trauma centre destinations and were more often received by an activated trauma team, even when adjusted for injury mechanism.Emergency medical dispatchers choose initial resources when serious injury is suspected after a call to the emergency medical communication centre. This study aimed to assess how dispatchers evaluate primary responses in trauma victims, with a special focus on the sex of the victim.MethodsEmergency medical dispatchers were interviewed using focus groups and a semistructured interview guide developed specifically for this study. Two vignettes describing typical and realistic injury scenarios were discussed. Verbatim transcripts of the conversations were analysed via systematic text condensation. The findings were reported in accordance with the Consolidated Criteria for Reporting Qualitative Studies (COREQ) checklist.ResultsThe analysis resulted in the main category “Tailoring the right response to the patient”, supported by three categories “Get an overview of location and scene safety”, “Patient condition” and “Injury mechanism and special concerns”. The informants consistently maintained that sex was not a relevant variable when deciding emergency medical response during dispatch and claimed that they rarely knew the sex of the patient before a response was implemented. Some of the participants also raised the question of whether the Norwegian trauma criteria reliably detect serious injury in women.ConclusionsThe results indicate that the emergency medical response is largely based on the national trauma criteria and that sex is of little or no importance during dispatch. The observed sex differences in the emergency medical response seems to be caused by other factors during the emergency medical response phase.

Maximizing network capacity, control and management in designing a telemedicine network: A review and recent challenges

Telemedicine networks have seen significant changes in their capacity, monitoring, management, and control framework during the previous decades. The evolution of network capacity, control, and management for Unmanned Aerial Vehicle (UAV) &amp; Software-Defined Networks (SDN) as support to telemedicine, artificial intelligence in telemedicine networks, and capabilities in designing a telemedicine network with respect to its performance and customization is presented in this study, with a historical history and a future view. The first section of the article goes over the history of traffic and capacity expansion, as well as future projections. By introducing a medical and image data communication protocol for telemedicine, the second section examines the technological constraints of expanding capacity in the era of UAV &amp; softwaredefined networking. The third section discusses ways to maximize network capacity by considering quality of service (QoS) capacity issues. Finally, the article explores how to construct a telemedicine network that can provide performance, customization, and capabilities to keep up with increased traffic in the coming decades. Research gaps and future directions were presented in the last section.

Medical communication, internalized “good mother” norms, and feminist self-identification as predictors of maternal burnout

IntroductionA rarely studied source of psychological discomfort for mothers is the communication received from medical professionals in the context of pregnancy, childbirth, the postpartum period, and pediatric care. To address this gap, we examined mothers’ recollections of medical communications that influenced their perceived stress levels in the context of good-mother normativity. We also explored how recollections of feedback on mothering in medical settings were associated with internalization of good-mother expectations, maternal burnout, length of motherhood, and feminist self-identification.MethodsWe collected the data through an online survey administered by a company that pre-establishes business relationships with potential survey takers. The survey-takers were 254 self-identified mothers, who answered open-ended questions about their recollections of medical communications related to good-motherhood norms. The participants also completed measures of maternal burnout, internalized good mother expectations, and feminist self-identification, and answered demographic questions such as age, education, number of children, and how long they had been mothers.ResultsParticipants who recalled discomfort-inducing medical communications that directly or indirectly referenced motherhood norms reported higher levels of internalized good-mother expectations and maternal burnout. A process model showed that the frequency of recalled medical communications, length of motherhood, and feminist self-identification moderated the relationship between the degree of internalization of good-mother expectations and maternal burnout. A significant association emerged between feminist self-identification and the recalled frequency of interactions with medical professionals that increased mothers’ perceived stress stemming from good-mother normativity.DiscussionThe findings of this study contribute to self-discrepancy theory as it relates to the social construction of mothers’ identities by focusing on whether and how often medical professionals reinforce or challenge good-mother social expectations. Another theoretical contribution of this study is that values and beliefs, such as feminist self-identification, can affect the recall of communications about social norms and are significantly associated with levels of internalized expectations and resulting burnout. In terms of practical implications, our findings suggest that medical professionals should be mindful of how they assess patients through the lens of the good-mother norms and also consider addressing the discomfort stemming from such normativity by asking mothers about their perceptions of social expectations and addressing unrealistic beliefs that aggravate mothers’ sense of self-discrepancy.

Perlocutionary Speech Act of Conveying Bad News in Medical Communication

Perlocutionary Speech Act of Conveying Bad News in Medical Communication

Impact of using active learning principles on perception of medical students toward e-learning environment

Introduction: The COVID-19 pandemic has necessitated a transition from face-to-face to e-learning, which caught many medical educators unaware. However, it is imperative to develop skills as an e-educator through the application of active learning (AL) principles based on Bloom’s taxonomy. This study highlights the effect of using AL principles on the perception of students toward an e-learning environment using Dundee ready education environment measure (DREEM) questionnaire. The aims of this study were as follows: (1) to introduce the AL principles during online teaching learning sessions. (2) To assess the feedback on the module among the students. (3) To evaluate the change of perception of students toward the e-learning environment through the DREEM questionnaire. Materials and Methods: An educational interventional study was carried out among (76) undergraduate students of a medical institution in coastal Andhra Pradesh. Perception toward the e-learning environment was collected through the DREEM questionnaire online before and after the intervention (application of AL principles as per the Bloom’s taxonomy during online T/L sessions). Statistical analysis: The data thus collected were analyzed using IBM SPSS version 20 statistical software, descriptive and inferential statistics for quantitative data and thematic analysis for qualitative data. Results: The Global DREEM score was 122 which was 62 before the intervention. Similarly, 68% reported positive perception which was only 37% initially. Students’ social self-perception scored lowest initially, but scores were improved to 2nd highest after the intervention. For a few items such as teacher-centered, nonstimulating teaching, not being able to memorize, lack of motivating environment, feedback, feeling lonely, bored, and not having a good support system, the individual scores were negative, i.e., &lt;2 which became positive, i.e., &gt;3.5 after. Conclusion: There was a significant change perceived by the students toward the e-learning environment with increased DREEM scores. Thus, this study concludes use of AL principles in online platforms is effective in improving students’ perception of the e-learning environment. The following core competencies are addressed in this article: Practice-based learning and improvement, Medical knowledge, Interpersonal and communication skills.

Diverse Integration of Simulated Patients in Medical Education for Communication, Language, and Clinical Skills in Hungary.

Medical education and communication training has been undergoing substantial changes recently in our globalized environment. Multidisciplinary simulation-based methods worldwide focus on improving effective clinical skills including history taking, physical examination, diagnostic skills, critical thinking, therapeutic skills, and others via interactions between medical students, trainees, and patients. Recently, Hungary has joined such global trends. The first simulated patient program in Hungary was developed at the University of Pécs Medical School in 2019 to aid effective patient-interviewing skills in language and communication classes. Under the supervision of linguists, communication specialists and medical professionals, the multidisciplinary program uses lay people to perform as simulated patients while using the languages of Hungarian, German, and English. Our simulated patient program plays a specific role in supporting students to learn languages for medical purposes, aiming to prepare them for handling the medical, linguistic, at the same, time emotional and sociocultural difficulties encountered while taking patient histories. Medical and linguistic experts evaluate student performance, provide feedback, and give tailored instruction so that students can advance their communicative and professional skills. This study discusses working formats and the role of constructive feedback exploring potential advantages and disadvantages, sharing ideas, and proposing recommendations on language- and communication-based integration of simulated patients. In our elective communication courses, undergraduate medical students learn to cope with a variety of patient situations through practicing medical emergencies, misunderstandings, and disagreements in a safe atmosphere provided by the MediSkillsLab. Among the benefits, we should emphasize that any course with a growing number of students can be accommodated by carefully designing the program, which allows for interprofessional collaboration. This program contributes to higher-quality medical education, promoting more skilled and compassionate healthcare specialists.

Design of a Dual-band Wearable Antenna Operating at 2.45 GHz and 5.8 GHz for Medical Communication Applications

Indonesia's natural demographic which consists of 16,771 islands makes it has many challenges in infrastructure development, especially in the health sector. According to data, Indonesia currently has 10,203 Puskesmas and 2,449 hospitals. In terms of the number of medical personnel, currently in Indonesia there are 124,449 medical personnel. However, of the large number of medical personnel, 61.12% are concentrated in Java and Bali. This inequality causes the need for a technology that makes it easier for medical personnel to provide services to the community. Wireless Body Area Network (WBAN) is one of developed technology that supports telemedical services. In WBAN, wearable antenna is needed as a transmitter to transmit data. In this paper, a compact wearable dual band antenna was designed in ISM frequency band of 2.45 GHz and 5.8 GHz. A combination of rectangular shape radiating structure and cross slot is constructed to achieve dual band frequency. Jeans Textile material with permitivity of 1.7 and thickness of 1 mm is used for fabricating the proposed antenna. The size of antenna is 52.3mm x 58.69mm. The proposed antenna is simulated with and without human body panthom using cst software. The simulations result indicates that antenna resonates at frequency 2.45 GHz and 5.8 GHz with peak gains of 6.92 dBi and 6.5 dBi. SAR values when the proposed antenna simulated at wrist phantom ​​are 0.326W/kg and 1.024W/kg. When simulated at chest phantom, the SAR values ​​are 0.554W/kg and 0.394W/kg. Therefore, The proposed wearable antenna design is well suited for telemedical services.