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Communication Etiquette in Medical Training

Communication Etiquette in Medical Training

Patient-centered communication can impact several aspects of the patient-doctor relationship, including disclosure of illness-related information and compliance with medical recommendations. Etiquette-based medicine involves simple patient-centered communication strategies that convey professionalism and respect to patients. “Research has shown that patients prefer physicians who practice etiquette-based medicine behaviors, most notably those who sit down and introduce themselves,” says Leonard S. Feldman, MD. Little is known, however, about  whether physicians in training are actually performing these easy-to-practice behaviors. An In-Depth Look In a study published in the Journal of Hospital Medicine, Dr. Feldman and colleagues sought to understand whether etiquette-based communication behaviors were practiced by trainees on inpatient medicine rotations. Trained observers followed 29 internal medicine interns in their first year out of medical school at Johns Hopkins Hospital and the University of Maryland Medical Center for 3 weeks. They witnessed 732 inpatient encounters and used an iPod Touch application to record whether the interns employed five key strategies in etiquette-based communication: 1) introducing oneself, 2) explaining one’s role in the patient’s care, 3) touching the patient, 4) asking open-ended questions, and 5) sitting down with the patient.   According to the findings, interns touched their patients—defined as either a physical exam or simply a handshake or a gentle, caring touch—during 65% of visits and asked open-ended questions 75% of the time. However, they introduced themselves only 40% of the time, explained their role in just 37% of cases, and sat down during only 9% of visits (Table). The study subjects performed all five of the recom-mended etiquette-based communication behaviors during just 4% of all patient encounters. Interns were only slightly more...
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