Teaching plain language to medical students: improving communication with disadvantaged patients.


Journal

BMC medical education
ISSN: 1472-6920
Titre abrégé: BMC Med Educ
Pays: England
ID NLM: 101088679

Informations de publication

Date de publication:
28 Jul 2021
Historique:
received: 05 01 2021
accepted: 16 07 2021
entrez: 29 7 2021
pubmed: 30 7 2021
medline: 31 7 2021
Statut: epublish

Résumé

Low health literacy underpins health inequality and leads to poor adherence to medical care and higher risk of adverse events and rehospitalization. Communication in plain language, therefore, is an essential skill for health professionals to acquire. Most medical education communication skill programs focus on verbal communication, while written communication training is scarce. ETGAR is a student delivered service for vulnerable patients after hospital discharge in which, amongst other duties, students 'translate' the medical discharge letters into plain language and share them with patients at a home visit. This study ascertains how this plain language training impacted on students' written communication skills using a tool designed for purpose. Students, in pairs, wrote three plain language discharge letters over the course of a year for patients whom they encountered in hospital. The students handed over and shared the letters with the patients during a post-discharge home visit. Structured feedback from course instructors was given for each letter. An assessment tool was developed to evaluate students' ability to tell the hospitalization narrative using plain and clear language. First and last letters were blindly evaluated for the entire cohort (74 letters; 87 students). Students scored higher in all assessment categories in the third letters, with significant improvement in overall score 3.5 ± 0.8 vs 4.1 ± 0.6 Z = -3.43, p = 0.001. The assessment tool's reliability was high α = 0.797, it successfully differentiated between plain language categories, and its score was not affected by letter length or patient's medical condition. Plain language discharge letters written for real patients in the context of experience-based learning improved in quality, providing students with skills to work effectively in an environment where poor health literacy is prevalent. ETGAR may serve as a model for learning written communication skills during clinical years, using the assessment tool for formative or summative evaluation.

Sections du résumé

BACKGROUND BACKGROUND
Low health literacy underpins health inequality and leads to poor adherence to medical care and higher risk of adverse events and rehospitalization. Communication in plain language, therefore, is an essential skill for health professionals to acquire. Most medical education communication skill programs focus on verbal communication, while written communication training is scarce. ETGAR is a student delivered service for vulnerable patients after hospital discharge in which, amongst other duties, students 'translate' the medical discharge letters into plain language and share them with patients at a home visit. This study ascertains how this plain language training impacted on students' written communication skills using a tool designed for purpose.
METHODS METHODS
Students, in pairs, wrote three plain language discharge letters over the course of a year for patients whom they encountered in hospital. The students handed over and shared the letters with the patients during a post-discharge home visit. Structured feedback from course instructors was given for each letter. An assessment tool was developed to evaluate students' ability to tell the hospitalization narrative using plain and clear language. First and last letters were blindly evaluated for the entire cohort (74 letters; 87 students).
RESULTS RESULTS
Students scored higher in all assessment categories in the third letters, with significant improvement in overall score 3.5 ± 0.8 vs 4.1 ± 0.6 Z = -3.43, p = 0.001. The assessment tool's reliability was high α = 0.797, it successfully differentiated between plain language categories, and its score was not affected by letter length or patient's medical condition.
CONCLUSIONS CONCLUSIONS
Plain language discharge letters written for real patients in the context of experience-based learning improved in quality, providing students with skills to work effectively in an environment where poor health literacy is prevalent. ETGAR may serve as a model for learning written communication skills during clinical years, using the assessment tool for formative or summative evaluation.

Identifiants

pubmed: 34320965
doi: 10.1186/s12909-021-02842-1
pii: 10.1186/s12909-021-02842-1
pmc: PMC8320047
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

407

Informations de copyright

© 2021. The Author(s).

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Auteurs

Doron Sagi (D)

Department of Population Health, Azrieli Faculty of Medicine, Bar-Ilan University, 8 Henrietta Szold, 1311502, Safed, Israel. doron.sagi@sheba.gov.il.
MSR- The Israel Center for Medical Simulation, Ramat-Gan, Israel. doron.sagi@sheba.gov.il.

Sivan Spitzer-Shohat (S)

Department of Population Health, Azrieli Faculty of Medicine, Bar-Ilan University, 8 Henrietta Szold, 1311502, Safed, Israel.
Center for Health and the Social Sciences, University of Chicago, Chicago, USA.

Michal Schuster (M)

Faculty of Humanities, University of the Free State, Bloemfontein, South Africa.

Ligat Daudi (L)

Department of Population Health, Azrieli Faculty of Medicine, Bar-Ilan University, 8 Henrietta Szold, 1311502, Safed, Israel.

Mary Catharine Joy Rudolf (MCJ)

Department of Population Health, Azrieli Faculty of Medicine, Bar-Ilan University, 8 Henrietta Szold, 1311502, Safed, Israel.

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Classifications MeSH