Teaching patient-centered communication skills: a telephone follow-up curriculum for medical students.
BACKGROUND
To encourage medical students' use of patient-centered skills in core clerkships, we implemented and evaluated a Telephone Follow-up Curriculum focusing on three communication behaviors: tailoring education to patients' level of understanding, promoting adherence by anticipating obstacles, and ensuring comprehension by having patients repeat the plans.


METHODS
The intervention group consisted of two different cohorts of third-year medical students in longitudinal clerkships (n=41); traditional clerkship students comprised the comparison group (n = 185). Intervention students telephoned one to four patients 1 week after seeing them in outpatient clinics or inpatient care to follow up on recommendations. We used surveys, focus groups, and clinical performance examinations to assess student perception, knowledge and skills, and behavior change.


RESULTS
Students found that the curriculum had a positive impact on patient care, although some found the number of calls excessive. Students and faculty reported improvement in students' understanding of patients' health behaviors, knowledge of patient education, and attitudes toward telephone follow-up. Few students changed patient education behaviors or called additional patients. Intervention students scored higher in some communication skills on objective assessments.


CONCLUSIONS
A patient-centered communication curriculum can improve student knowledge and skills. While some intervention students perceived that they made too many calls, our data suggest that more calls, an increased sense of patient ownership, and role modeling by clerkship faculty may ensure incorporation and application of skills.
Department of Family and Community Medicine, University of California, San Francisco, CA, USA; Gsaba@fcm.ucsf.edu.
George W
GW
Saba
Department of Medicine, University of California, San Francisco, CA, USA; Veterans Affairs Medical Center, San Francisco, CA, USA.
Calvin L
CL
Chou
Department of Medicine, University of California, San Francisco, CA, USA.
Jason
J
Satterfield
Department of Medicine, University of California, San Francisco, CA, USA.
Arianne
A
Teherani
Department of Medicine, University of California, San Francisco, CA, USA.
Karen
K
Hauer
Veterans Affairs Medical Center, San Francisco, CA, USA; Department of Neurology, University of California, San Francisco, CA, USA.
Ann
A
Poncelet
Department of Pediatrics, University of California, San Francisco, CA, USA.
Huiju Carrie
HC
Chen
D002982:Clinical Clerkship / Q000458:organization & administration; D002983:Clinical Competence; D003142:Communication; D003479:Curriculum; D004504:Education, Medical, Undergraduate / Q000458:organization & administration*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D018802:Patient-Centered Care / Q000458:organization & administration*; D010817:Physician-Patient Relations; D015397:Program Evaluation; D013337:Students, Medical; D013689:Telephone
clinical clerkship; continuity of patient care; education; medical; patient-centered care; physician–patient relationship; undergraduate