A study, published in Clinical Gastroenterology and Hepatology, assessed the communication skills of GI fellows.
Noami Chaudhary, MD, of New York City-based New York University School of Medicine, and colleagues developed four cases highlighting different liver disease characteristics and created a four-station objective structured clinical examination. Twelve fellows from four GI training programs participated.
The cases were related to hepatitis B, acute hepatitis C, new diagnosis of cirrhosis and end-stage cirrhotic nontransplant candidates.
The patients measured the fellows' communication metrics through a checklist. Faculty and patients observed the cases to provide feedback.
Here's what they found:
1. The majority of fellows successfully summarized findings and discussed an action plan in the new diagnosis of cirrhosis (76.92 percent) and hepatitis C cases (100 percent).
2. The fellows struggled when discussing hepatitis B (30.77 percent) and the end-of-life cases (41.67 percent.)
3. Between 22 and 33 percent of fellows believed they did a good job during the exams, however 67 percent of fellows believed they did a good job in the end-of-life case.
4. Researchers believed the amount of information the fellows had to cover in a single visit was their biggest challenge.
Researchers concluded that patient and GI fellow observations varied greatly. For example, the fellows "believed they excelled in the end-of-life case." However the patients disagreed, believing only a small percentage of the fellows excelled at summarizing and discussing the plan.
Researchers said, "This discrepancy and others highlight important areas of focus in training programs. [Objective structured clinical examinations] are important to help the fellows facilitate striking the right balance of information delivery and empathy, and this will lead to better patient education, compliance, rapport, and satisfaction."