What and how are students taught about communicating risks to patients? Analysis of a medical curriculum.


Journal

PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081

Informations de publication

Date de publication:
2020
Historique:
received: 22 07 2019
accepted: 11 05 2020
entrez: 30 5 2020
pubmed: 30 5 2020
medline: 18 8 2020
Statut: epublish

Résumé

Communication is a core competence in medical care. Failure of physicians to properly communicate inherent risks of medical interventions has been linked with inadequate training at school. This study analyses a medical curriculum for assessing the content and quality of teaching risk communication to students. A checklist based on the national guidelines of core competencies on risk communication required of physicians was developed. Participant observers surveyed all teaching sessions at a medical school during a semester to record the frequency, characteristics and clinical context used by lectures during classes. Data were analyzed using statistical and descriptive methods to determine the prevalence and quality of teaching content. 231 teaching sessions were surveyed. The inter-rater reliability was 81%. Lecturers mentioned topics of risk communication in 61.5% of teaching sessions (83.7% in surgery, 43.3% in internal medicine) but core biostatistics concepts were not discussed in more than 80% of these sessions. Important topics such as patient safety and preventable diseases were underrepresented. Risk communication was mainly taught in large-group, theoretical sessions and rarely with supplementary teaching material (7.4%). Students asked questions in 15.2% of courses, more often in surgery classes than in internal medicine. Statistical and clinical topics relevant for teaching risk communication to medical students are not only underrepresented but also minimally explained by lecturers. Supplementary material on risk communication is rarely provided to students during classes. High-resource demanding, small-group teaching formats are not necessarily interactive as students ask few questions.

Sections du résumé

BACKGROUND
Communication is a core competence in medical care. Failure of physicians to properly communicate inherent risks of medical interventions has been linked with inadequate training at school. This study analyses a medical curriculum for assessing the content and quality of teaching risk communication to students.
METHODS
A checklist based on the national guidelines of core competencies on risk communication required of physicians was developed. Participant observers surveyed all teaching sessions at a medical school during a semester to record the frequency, characteristics and clinical context used by lectures during classes. Data were analyzed using statistical and descriptive methods to determine the prevalence and quality of teaching content.
RESULTS
231 teaching sessions were surveyed. The inter-rater reliability was 81%. Lecturers mentioned topics of risk communication in 61.5% of teaching sessions (83.7% in surgery, 43.3% in internal medicine) but core biostatistics concepts were not discussed in more than 80% of these sessions. Important topics such as patient safety and preventable diseases were underrepresented. Risk communication was mainly taught in large-group, theoretical sessions and rarely with supplementary teaching material (7.4%). Students asked questions in 15.2% of courses, more often in surgery classes than in internal medicine.
CONCLUSION
Statistical and clinical topics relevant for teaching risk communication to medical students are not only underrepresented but also minimally explained by lecturers. Supplementary material on risk communication is rarely provided to students during classes. High-resource demanding, small-group teaching formats are not necessarily interactive as students ask few questions.

Identifiants

pubmed: 32470064
doi: 10.1371/journal.pone.0233682
pii: PONE-D-19-19573
pmc: PMC7259606
doi:

Types de publication

Journal Article Observational Study Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e0233682

Déclaration de conflit d'intérêts

The authors have declared that no competing interests exist.

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Auteurs

Franziska Baessler (F)

Department of General, Internal and Psychosomatic Medicine, Center for Psychosocial Medicine, Heidelberg University Hospital, Heidelberg, Germany.

Joshua Weidlich (J)

Department of General, Internal and Psychosomatic Medicine, Center for Psychosocial Medicine, Heidelberg University Hospital, Heidelberg, Germany.

Sophie Schweizer (S)

Department of Gynecology and Obstetrics, Heidelberg University Hospital, Heidelberg, Germany.

Anja Ciprianidis (A)

Department of General, Internal and Psychosomatic Medicine, Center for Psychosocial Medicine, Heidelberg University Hospital, Heidelberg, Germany.

Marina Bartolovic (M)

Department of General Psychiatry, Center for Psychosocial Medicine, Heidelberg University Hospital, Heidelberg, Germany.

Ali Zafar (A)

Department of General, Internal and Psychosomatic Medicine, Center for Psychosocial Medicine, Heidelberg University Hospital, Heidelberg, Germany.

Michael Wolf (M)

Department of General, Internal and Psychosomatic Medicine, Center for Psychosocial Medicine, Heidelberg University Hospital, Heidelberg, Germany.

Fabienne Louise Wagner (FL)

Department of General, Internal and Psychosomatic Medicine, Center for Psychosocial Medicine, Heidelberg University Hospital, Heidelberg, Germany.

Tabea Chiara Baumann (TC)

Department of General, Internal and Psychosomatic Medicine, Center for Psychosocial Medicine, Heidelberg University Hospital, Heidelberg, Germany.

André L Mihaljevic (AL)

Department of General, Visceral and Transplantation Surgery, University Hospital Heidelberg, Heidelberg, Germany.

Beate Ditzen (B)

Institute of Medical Psychology, Heidelberg University Hospital, Heidelberg, Germany.

Daniela Roesch-Ely (D)

Department of General Psychiatry, Center for Psychosocial Medicine, Heidelberg University Hospital, Heidelberg, Germany.

Christoph Nikendei (C)

Department of General, Internal and Psychosomatic Medicine, Center for Psychosocial Medicine, Heidelberg University Hospital, Heidelberg, Germany.

Jobst-Hendrik Schultz (JH)

Department of General, Internal and Psychosomatic Medicine, Center for Psychosocial Medicine, Heidelberg University Hospital, Heidelberg, Germany.

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Classifications MeSH