title: Results from the First Year of Implementation of CONSULT: Consultation with Novel Methods and Simulation for UME Longitudinal Training.
abstract: BACKGROUND
  An important area of communication in healthcare is the consultation. Existing literature suggests that formal training in consultation communication is lacking. We aimed to conduct a targeted needs assessment of third-year students on their experience calling consultations, and based on these results, develop, pilot, and evaluate the effectiveness of a consultation curriculum for different learner levels that can be implemented as a longitudinal curriculum.
  
  
  METHODS
  Baseline needs assessment data were gathered using a survey completed by third-year students at the conclusion of the clinical clerkships. The survey assessed students' knowledge of the standardized consultation, experience and comfort calling consultations, and previous instruction received on consultation communication. Implementation of the consultation curriculum began the following academic year. Second-year students were introduced to Kessler's 5 Cs consultation model through a didactic session consisting of a lecture, viewing of "trigger" videos illustrating standardized and informal consults, followed by reflection and discussion. Curriculum effectiveness was assessed through pre- and post- curriculum surveys that assessed knowledge of and comfort with the consultation process. Fourth-year students participated in a consultation curriculum that provided instruction on the 5 Cs model and allowed for continued practice of consultation skills through simulation during the Emergency Medicine clerkship. Proficiency in consult communication in this cohort was assessed using two assessment tools, the Global Rating Scale and the 5 Cs Checklist.
  
  
  RESULTS
  The targeted needs assessment of third-year students indicated that 93% of students have called a consultation during their clerkships, but only 24% received feedback. Post-curriculum, second-year students identified more components of the 5 Cs model (4.04 vs. 4.81, p<0.001) and reported greater comfort with the consultation process (0% vs. 69%, p<0.001). Post- curriculum, fourth-year students scored higher in all criteria measuring consultation effectiveness (p<0.001 for all) and included more necessary items in simulated consultations (62% vs. 77%, p<0.001).
  
  
  CONCLUSIONS
  While third-year medical students reported calling consultations, few felt comfortable and formal training was lacking. A curriculum in consult communication for different levels of learners can improve knowledge and comfort prior to clinical clerkships and improve consultation skills prior to residency training.
authors.affiliation: University of Chicago, Section of Emergency Medicine, Chicago, Illinois.
authors.forename: Keme
authors.initials: K
authors.lastname: Carter
authors.affiliation: University of Chicago Pritzker School of Medicine, Chicago, Illinois.
authors.forename: Andrew
authors.initials: A
authors.lastname: Golden
authors.affiliation: University of Chicago, Section of Emergency Medicine, Chicago, Illinois.
authors.forename: Shannon
authors.initials: S
authors.lastname: Martin
authors.affiliation: NorthShore University HealthSystem, Division of Emergency Medicine, Evanston, Illinois.
authors.forename: Sarah
authors.initials: S
authors.lastname: Donlan
authors.affiliation: University of Chicago, Section of Emergency Medicine, Chicago, Illinois.
authors.forename: Sara
authors.initials: S
authors.lastname: Hock
authors.affiliation: University of Chicago, Section of Emergency Medicine, Chicago, Illinois.
authors.forename: Christine
authors.initials: C
authors.lastname: Babcock
authors.affiliation: University of Chicago, Section of Hospital Medicine, Chicago, Illinois.
authors.forename: Jeanne
authors.initials: J
authors.lastname: Farnan
authors.affiliation: University of Chicago, Section of General Internal Medicine, Chicago, Illinois.
authors.forename: Vineet
authors.initials: V
authors.lastname: Arora
mesh_terms: D002641:Chicago; D002982:Clinical Clerkship / Q000379:methods* / Q000592:standards; D002983:Clinical Competence; D003142:Communication; D003479:Curriculum; D004504:Education, Medical, Undergraduate / Q000379:methods* / Q000592:standards; D004635:Emergency Medicine / Q000193:education*; D006801:Humans; D017145:Models, Educational; D020380:Needs Assessment; D016730:Program Development; D015397:Program Evaluation; D012017:Referral and Consultation; D000066908:Simulation Training / Q000379:methods*