Resident scores on a patient satisfaction survey: evidence for maintenance of communication skills throughout residency.
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ABSTRACT:
SUBMITTER: Stewart EA
PROVIDER: S-EPMC3244313 | biostudies-other | 2011 Dec
REPOSITORIES: biostudies-other
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Project description:BackgroundSkilled physician communication is a key component of patient experience. Large-scale studies of exposure to communication skills training and its impact on patient satisfaction have not been conducted.ObjectiveWe aimed to examine the impact of experiential relationship-centered physician communication skills training on patient satisfaction and physician experience.DesignThis was an observational study.SettingThe study was conducted at a large, multispecialty academic medical center.ParticipantsParticipants included 1537 attending physicians who participated in, and 1951 physicians who did not participate in, communication skills training between 1 August 2013 and 30 April 2014.InterventionAn 8-h block of interactive didactics, live or video skill demonstrations, and small group and large group skills practice sessions using a relationship-centered model.Main measuresHospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), Clinician and Group Consumer Assessment of Healthcare Providers and Systems (CGCAHPS), Jefferson Scale of Empathy (JSE), Maslach Burnout Inventory (MBI), self-efficacy, and post course satisfaction.Key resultsFollowing the course, adjusted overall CGCAHPS scores for physician communication were higher for intervention physicians than for controls (92.09 vs. 91.09, p < 0.03). No significant interactions were noted between physician specialty or baseline CGCAHPS and improvement following the course. Significant improvement in the post-course HCAHPS Respect domain adjusted mean was seen in intervention versus control groups (91.08 vs. 88.79, p = 0.02) and smaller, non-statistically significant improvements were also seen for adjusted HCAHPS communication scores (83.95 vs. 82.73, p = 0.22). Physicians reported high course satisfaction and showed significant improvement in empathy (116.4 ± 12.7 vs. 124 ± 11.9, p < 0.001) and burnout, including all measures of emotional exhaustion, depersonalization, and personal accomplishment. Less depersonalization and greater personal accomplishment were sustained for at least 3 months.ConclusionsSystem-wide relationship-centered communication skills training improved patient satisfaction scores, improved physician empathy, self-efficacy, and reduced physician burnout. Further research is necessary to examine longer-term sustainability of such interventions.
| S-EPMC4907940 | biostudies-literature
Project description:IntroductionThe discharge conversation is a critical component of the emergency department encounter. Studies suggest that emergency medicine (EM) residency education is deficient in formally training residents on the patient discharge conversation. Our goal was to assess the proficiency of EM residents in addressing essential elements of a comprehensive discharge conversation; identify which components of the discharge conversation are omitted; introduce "DC HOME," a standardized discharge mnemonic; and determine whether its implementation improved resident performance and patient satisfaction.MethodsThis was a prospective observational pre- and post-intervention study done by convenience sampling of 400 resident discharge encounters. Resident physicians were observed by attending physicians who completed an evaluation, answering "yes" or "no" as to whether residents addressed six components of a comprehensive discharge. The six components include the following: diagnosis; care rendered; health and lifestyle modifications; obstacles after discharge; medications; and expectations - or "DC HOME." Didactics introducing the mnemonic "DC HOME" was provided to resident physicians. Patient feedback and satisfaction were collected after each encounter, and we recorded differences between pre-intervention and post-intervention encounters.ResultsResident physicians improved significantly in all six components of "DC HOME" from pre-and-post intervention: discharge diagnosis (P = 0.0036) and the remaining five components (P<0.0001). There was a statistically significant improvement in patients' perception for health and lifestyle modifications, obstacles after discharge, medications, expectations after discharge (P<0.0001), and discharge diagnosis (P = 0.0029). Patient satisfaction scores improved significantly (P = 0.005). Time spent with patients during discharge increased from 2 minutes and 42 seconds to 4 minutes and 4 seconds (P<0.0001).ConclusionEM residents frequently omit key components of the discharge conversation. The implementation of the "DC HOME" discharge mnemonic improves resident discharge performance, patient perception, and overall patient satisfaction.
| S-EPMC7806327 | biostudies-literature
Project description:Recent empirical findings document the role of nonverbal communication in cross-cultural interactions. As ethnic minority health disparities in the United States continue to persist, physician competence in this area is important. We examine physicians' abilities to decode nonverbal emotions across cultures, our hypothesis being that there is a relationship between physicians' skill in this area and their patients' satisfaction and outcomes. First part tested Caucasian and South Asian physicians' cross-cultural emotional recognition ability. Physicians completed a fully balanced forced multiple-choice test of decoding accuracy judging emotions based on facial expressions and vocal tones. In the second part, patients reported on satisfaction and health outcomes with their physicians using a survey. Scores from the patient survey were correlated with scores from the physician decoding accuracy test. Physicians, regardless of their ethnicity, were more accurate at rating Caucasian faces and vocal tones. South Asian physicians were no better at decoding the facial expressions or vocal tones of South Asian patients, who were also less likely to be satisfied with the quality of care provided by their physicians and to adhere to their physicians' recommendations. Implications include the development of cultural sensitivity training programs in medical schools, continuing medical education and public health programs.
| S-EPMC3389700 | biostudies-literature
Project description:BackgroundDespite the critical importance of well-being during residency training, only a few Canadian studies have examined stress in residency and none have examined well-being resources. No recent studies have reported any significant concerns with respect to perceived stress levels in residency. We investigated the level of perceived stress, mental health and understanding and need for well-being resources among resident physicians in training programs in Alberta, Canada.MethodsA mail questionnaire was distributed to the entire resident membership of PARA during 2003 academic year. PARA represents each of the two medical schools in the province of Alberta.ResultsIn total 415 (51 %) residents participated in the study. Thirty-four percent of residents who responded to the survey reported their life as being stressful. Females reported stress more frequently than males (40% vs. 27%, p < 0.02). Time pressure was reported as the number one factor contributing to stress (44% of males and 57% of females). A considerable proportion of residents would change their specialty program (14%) and even more would not pursue medicine (22%) if given the opportunity to relive their career. Up to 55% of residents reported experiencing intimidation and harassment. Intimidation and harassment was strongly related to gender (12% of males and 38% of females). Many residents (17%) rated their mental health as fair or poor. This was more than double the amount reported in the Canadian Community Health Survey from the province (8%) or the country (7%). Residents highly valued their colleagues (67%), program directors (60%) and external psychiatrist/psychologist (49%) as well-being resources. Over one third of residents wished to have a career counselor (39%) and financial counselor (38%).ConclusionMany Albertan residents experience significant stressors and emotional and mental health problems. Some of which differ among genders. This study can serve as a basis for future resource application, research and advocacy for overall improvements to well-being during residency training.
| S-EPMC1183209 | biostudies-literature
Project description:ObjectiveThe purpose of this study was to assess the relationship between emergency medicine (EM) resident and attending physician patient satisfaction scores.MethodsWe added four resident questions to the standard Press Ganey survey used at a large, urban, university hospital with a PGY-1 to -4 EM residency. The resident questions were identical to the traditional attending questions. Press Ganey distributed the modified survey to a random sample of 30% of discharged patients. We assessed the correlation between resident and attending top-box Press Ganey scores using Pearson's coefficients. Two-tailed two-sample comparisons of proportions were used to compare top-box responses between residents and attendings.ResultsFrom September 1, 2012, to August 31, 2015, a total of 66,216 patients received surveys, and 7,968 responded, resulting in a 12.03% response rate, similar to Press Ganey survey response rate at comparable peer institutions. Patients were able to discriminate between residents and attendings; however, 751 surveys did not contain responses for residents, resulting in a total number of 6,957. All 64 of the EM residents had a minimum of 5 or more surveys returned. There was a high degree of correlation between resident and attending top-box scores with correlation coefficients ranging from 0.75 to 0.80. However, the proportion of top-box scores was consistently higher for residents (p < 0.05).ConclusionsThere is a high degree of correlation between resident and attending top-box scores on Press Ganey surveys, with residents scoring slightly higher than attendings. The addition of resident questions to the standard Press Ganey survey does not appear to decrease overall attending scores.
| S-EPMC6001603 | biostudies-literature
Project description:Study objectiveWith the focus of patient-centered care in healthcare organizations, patient satisfaction plays an increasingly important role in healthcare quality measurement. We sought to determine whether an automated patient satisfaction survey could be effectively used to identify outlying anesthesiologists.DesignRetrospective Observational Study.SettingVanderbilt University Medical Center (VUMC).MeasurementsPatient satisfaction data were obtained between October 24, 2016 and November 1, 2017. A multivariable ordered probit regression was conducted to evaluate the relationship between the mean scores of responses to Likert-scale questions on SurveyVitals' Anesthesia Patient Satisfaction Questionnaire 2. Fixed effects included demographics, clinical variables, providers and surgeons. Hypothesis tests to compare each individual anesthesiologist with the median-performing anesthesiologist were conducted.Main resultsWe analyzed 10,528 surveys, with a 49.5% overall response rate. Younger patient (odds ratio (OR) 1.011 [per year of age]; 95% confidence interval (CI) 1.008 to 1.014; p < 0.001), regional anesthesia (versus general anesthesia) (OR 1.695; 95% CI 1.186 to 2.422; p = 0.004) and daytime surgery (versus nighttime surgery) (OR 1.795; 95% CI 1.091 to 2.959; p = 0.035) were associated with higher satisfaction scores. Compared with the median-ranked anesthesiologist, we found the adjusted odds ratio for an increase in satisfaction score ranged from 0.346 (95% CI 0.158 to 0.762) to 1.649 (95% CI 0.687 to 3.956) for the lowest and highest scoring providers, respectively. Only 10.10% of anesthesiologists at our institution had an odds ratio for satisfaction with a 95% CI not inclusive of 1.ConclusionsPatient satisfaction is impacted by multiple factors. There was very little information in patient satisfaction scores to discriminate the providers, after adjusting for confounding. While patient satisfaction scores may facilitate identification of extreme outliers among anesthesiologists, there is no evidence that this metric is useful for the routine evaluation of individual provider performance.
| S-EPMC7387167 | biostudies-literature
Project description:OBJECTIVE: We describe a collaboration between the graduate medical education office and the Henry Ford Health System's Office of Clinical Quality and Safety to create an institution-wide communication skills curriculum pertinent to the institution's safety and patient- and family-centered care initiatives. METHODS: A multidisciplinary committee provided oversight for the curriculum design and used sentinel event and other quality and safety data to identify specific target areas. The curriculum consisted of 3 courses: "Informed Consent," "Sharing Bad News," and "Disclosure of Unanticipated Events." Each course included 3 components: a multimedia online module; small group discussions led by the program director that focused on the use of communication scripts; and 2 objective structured clinical examinations (OSCEs) requiring residents to demonstrate use of the communication scripts. All first-year residents (N = 145) and faculty (N = 30) from 20 residency programs participated in this initiative. Evaluation of the residents consisted of a self-assessment; the standardized patients' assessment of the residents' performance; and faculty assessment of resident performance with verbal feedback. RESULTS: Survey data showed that residents found the courses valuable, with residents identifying communication scripts they would use in clinical settings. Focus groups with faculty highlighted that the resident debriefing sessions provided them with insight into a resident's communication skills early in their training. CONCLUSION: Our institutional curriculum was developed in a collaborative manner, and used an evidence-based approach to teach communication skills relevant to institutional safety and quality initiatives. Other institutions 5 wish to adopt our strategy of departmental collaboration and alignment of resident education with institutional initiatives.
| S-EPMC3244319 | biostudies-other
Project description:BackgroundPhysicians and physicists are expected to contribute to patient safety and quality improvement (QI) in Radiation Oncology (RO), but prior studies suggest that training for this may be inadequate. RO and medical physics (MP) program directors (PDs) were surveyed to better understand the current patient safety/QI training in their residency programs.MethodsPDs were surveyed via email in January 2017. Survey questions inquired about current training, curriculum elements, and barriers to development and/or improvement of safety and QI training.ResultsEighty-nine RO PDs and 84 MP PDs were surveyed, and 21 RO PDs (28%) and 31 MP PDs (37%) responded. Both RO and MP PDs had favorable opinions of current safety and QI training, and used a range of resources for program development, especially safety and QI publications. Various curriculum elements were reported. Curriculum elements used by RO and MP PDs were similar, except RO were more likely than MP PDs to implement morbidity and mortality (M&M) conference (72% vs. 45%, p < 0.05). RO and MP PDs similarly cited various barriers, but RO PDs were more likely to cite lack of experience than MP PDs (40% vs. 16%, p < 0.05). PDs responded similarly independent of whether they reported using a departmental incident learning system (ILS) or not.ConclusionsPDs view patient safety/QI as an important part of resident education. Most PDs agreed that residents are adequately exposed to patient safety/QI and prepared to meet the patient safety/QI expectations of clinical practice. This conflicts with other independent studies that indicate a majority of residents feel their patient safety/QI training is inadequate and lacks formal exposure to QI tools.
| S-EPMC6154943 | biostudies-literature
Project description:Physician burnout is recognized as reversible with the potential to negatively influence quality of care and patient outcomes. The study objective was to evaluate associations between patient satisfaction scores (PSS) and physicians' perceptions of job satisfaction and burnout via a physician survey. Eighty two out of 107 report PSS are institutionally tracked, with 23/107 and 39/107 reporting PSS utilization in financial compensation or performance review, respectively. Fifty four out of 107, report pressure to emphasize PSS; 63/107, report PSS having negative effect on job satisfaction; 31/107 considered leaving their job or career due to PSS and 84/107 report PSS contribute to burnout. In the cohort of physicians treating patients with spine pain who responded to this survey, PSS are associated with decreased job satisfaction and increased burnout.
| S-EPMC7787140 | biostudies-literature
Project description:AimProfessional communication between nurse and patient has a significant role in patient satisfaction with nursing care. The aim of this study was to assess nurse-patient communication and patient's satisfaction from nursing services in the burn wards of women and men.DesignParticipants were all patients admitted to the Burn wards at the Sina Hospital of Tabriz between September-December 2018. Nurse-patient communication and patient's satisfaction were assessed using at the time of discharge. Data were analysed by SPSS applying descriptive and inferential statistics.ResultsThe results show that most patients were dissatisfied with nursing care. More than 80% did not know their nurse. There was a correlation between nurse-patient communication and patient satisfaction with nursing care and the sex variable was found to be significantly correlated with patients' satisfaction level. The weakness of nurses 'communication with patients was evident in our study and patients were dissatisfied from this kind of communication, and consequently, patients' satisfaction was reported very low. Improving the satisfaction of patients in the hospital should be the priorities of the hospital managers. Therefore, by educating staff, especially nurses, identifying motivating factors as well as identifying dissatisfaction factors, improved patient satisfaction.
| S-EPMC6650658 | biostudies-literature