To determine whether Intensive Care Unit (ICU) communication skills of fourth year medical students could be improved by an educational intervention.
Prospective study conducted from August, 2003 to May, 2004. Tertiary care university teaching hospital. All fourth year students were eligible to participate during their mandatory four-week CCM clerkship. The educational intervention included formal teaching of a communication framework for the initial meeting with the family member of an ICU patient, followed by a practice session with an actor playing the role of a standardized family member (SFM) of a fictional patient. At the beginning of the CCM rotation, the intervention group received the educational session, while students in the control group did not. At the end of each CCM rotation, all students interacted with a different SFM portraying a different fictional scenario. Sessions were videotaped, and were scored by both investigators together using a standardized grading tool across four major domains: Introduction, Gathering Information, Imparting Information, Setting Goals and Expectations. Ten study subjects were chosen at random six months later, and their videotapes again reviewed and scored by both investigators blinded to the initial scoring results.
A total of 106 (97%) medical students agreed to participate in the study. The total mean score as well as the scores for the four domains for the intervention group were significantly higher than for the control group (p <0.0001). These differences remained statistically different after adjusting for multiple comparisons. The observed intra-rater agreement for the communication assessment instrument was good (κ = 0.69).
The communication skills of fourth year medical students can be improved by teaching and then practicing a framework for an initial ICU communication episode with a SFM.
This educational initiative has important implications regarding teaching and assessing core critical care communication skills in the medical school curriculum.
Scott Lorin, None.