title: The 5Cs of Consultation: Training Medical Students to Communicate Effectively in the Emergency Department.
abstract: Effective communication is critical for health care professionals, particularly in the Emergency Department (ED). However, currently, there is no standardized consultation model that is consistently practiced by physicians or used for training medical graduates. Recently, the 5Cs of Consultation model (Contact, Communicate, Core Question, Collaborate, and Close the Loop) has been studied in Emergency Medicine residents using simulated consultation scenarios.
  
  
  
  Using an experimental design, we aimed to evaluate the efficacy of the 5Cs consultation model in a novel learner population (medical students) and in a "real time and real world" clinical setting.
  
  
  
  A prospective, randomized, controlled study was conducted at eight large, academic, urban, tertiary-care medical centers (U.S. and Canada). Intervention involved two experimental groups (asynchronous and live training) compared to a baseline control group. All participants placed up to four consult phone calls. A senior physician observed and assessed each call using a preapproved 5Cs checklist and a Global Rating Scale (GRS).
  
  
  
  Participants who received training (asynchronous or live) scored significantly higher on the 5Cs checklist total and GRS than the control group. Both training methods (asynchronous and live) were equally effective. Importantly, learning gains were sustained as students' 5Cs checklist total and GRS scores remained consistently higher at their second, third, and fourth consult (relative to their first consult). At posttest, all participants reported feeling more confident and competent in relaying patient information.
  
  
  
  Medical students can be trained to use the 5Cs model in a timely, inexpensive, and convenient manner and increase effectiveness of physician consultations originating from the ED.
authors.affiliation: Durham VA Medical Center, Duke University, Durham, North Carolina.
authors.forename: Chad S
authors.initials: CS
authors.lastname: Kessler
authors.affiliation: College of Medicine, University of Illinois at Chicago, Chicago, Illinois.
authors.forename: Kashyap Komarraju
authors.initials: KK
authors.lastname: Tadisina
authors.affiliation: Department of Emergency Medicine, Drexel University College of Medicine, Philadelphia, Pennsylvania.
authors.forename: Mark
authors.initials: M
authors.lastname: Saks
authors.affiliation: Department of Emergency Medicine, Virginia Commonwealth University College of Medicine, Richmond, Virginia.
authors.forename: Doug
authors.initials: D
authors.lastname: Franzen
authors.affiliation: Department of Emergency Medicine, University of Saskatchewan College of Medicine, Saskatoon, Saskatchewan, Canada.
authors.forename: Rob
authors.initials: R
authors.lastname: Woods
authors.affiliation: Department of Emergency Medicine, University of California San Francisco Fresno School of Medicine, Fresno, California.
authors.forename: Kenny V
authors.initials: KV
authors.lastname: Banh
authors.affiliation: Department of Emergency Medicine, Christiana Care Health System, Newark, Delaware.
authors.forename: Richard
authors.initials: R
authors.lastname: Bounds
authors.affiliation: Department of Emergency Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio.
authors.forename: Michael
authors.initials: M
authors.lastname: Smith
authors.affiliation: Department of Emergency Medicine, Oregon Health & Science University, Portland, Oregon.
authors.forename: Nicole
authors.initials: N
authors.lastname: Deiorio
authors.affiliation: Department of Medical Education, University of Illinois at Chicago, Chicago, Illinois.
authors.forename: Alan
authors.initials: A
authors.lastname: Schwartz
mesh_terms: D000328:Adult; D057189:Checklist; D002982:Clinical Clerkship / Q000379:methods*; D003299:Cooperative Behavior; D004504:Education, Medical, Undergraduate / Q000379:methods*; D004521:Educational Measurement; D004635:Emergency Medicine / Q000193:education*; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D033183:Interdisciplinary Communication; D008297:Male; D017145:Models, Educational; D016544:Patient Simulation; D015397:Program Evaluation; D011446:Prospective Studies; D012017:Referral and Consultation; D020377:Self Efficacy; D055815:Young Adult
keywords: checklist; consultation; handoffs; medical education