Kuriakose, Aster, Arachchige, Subodhini Puhambugoda, Emeto, Theophilus I., Hiskens, Matthew I., and Hariharan, Gopakumar (2024) Descriptive feedback with targeted education to improve telephonic escalation of care: a simulation-based study. BMC Medical Education, 24. 281.

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Abstract

Background: Awareness of communication failures in healthcare has necessitated the implementation of standardized, validated handover tools such as Identification, Situation, Background, Assessment, Recommendation (ISBAR). Although educational sessions improve communication, the effectiveness of individualized care escalation communication training is unknown. The primary aim was to conduct a simulation-based study to assess individualized one-on-one communication training for junior medical doctors for improving care escalation in pediatric emergencies. The secondary aim was to assess the evaluation of the training.

Methods: The prospective observational study assessed participants pre- and post-intervention. In Session One, participants presented a written case scenario telephonically to two senior pediatricians. Fifty participants were scored using an 18-item checklist based on the ISBAR tool and “free text” responses. Immediately following case presentations, participants completed individualized one-on-one 30-minute educational sessions regarding self-reflection, didactic teaching, and constructive feedback based on the ISBAR. Session Two included a second case presentation and reassessment. We conducted qualitative analysis of supervisor’s feedback on performance and trainee doctor’s evaluation of the training.

Results: There was significant improvement in 8 of the 18 components of the ISBAR checklist. All elements of care escalation were significantly improved, and overall communication was higher post-intervention (P < 0.001); however, no improvement was noted in participants’ explorations of differential diagnoses (P = 0.263). The qualitative analysis identified themes of improved urgency in seeking senior support and conversational clarity from supervisors, and improved intervention quality and self-confidence from participants.

Conclusions: Individualized communication training may improve pediatric emergency care escalation and communication among junior doctors.

Item ID:	82490
Item Type:	Article (Research - C1)
ISSN:	1472-6920
Copyright Information:	© Crown 2024. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
Date Deposited:	18 Apr 2024 04:23
FoR Codes:	39 EDUCATION > 3901 Curriculum and pedagogy > 390110 Medicine, nursing and health curriculum and pedagogy @ 50% 49 MATHEMATICAL SCIENCES > 4905 Statistics > 490502 Biostatistics @ 50%
SEO Codes:	20 HEALTH > 2002 Evaluation of health and support services > 200203 Health education and promotion @ 50% 16 EDUCATION AND TRAINING > 1601 Learner and learning > 160104 Professional development and adult education @ 50%
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