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A design-based Research project to develop an intervention to help international medical graduates (physicians trained abroad) improve their English as a Second Language (ESL) and communication.
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1) The document discusses patient-centered care and communication in healthcare settings, using the example of a 44-year-old female brought to the emergency department after an overdose.
2) In this example, the physician spoke very quickly to the family without ensuring they understood the medical procedures, leading to confusion and a "code gray" situation during intubation.
3) Effective communication is important for positive patient and family experiences during medical emergencies, and providers should use understandable language instead of medical terminology when speaking to families.
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Imgs presentation
- 3. “THEY UNDERSTAND!” “WE UNDERSTAND!” ….NOT SO MUCH! Physicians tend to overestimate their own communicative effectiveness (Broquet & Punwani, 2012; Dahm, Yates, Ogden, Rooney, & Sheldon, 2015; Lineberry et al., 2015). In one ER discharge study, 78% percent of patients misunderstood at least one aspect of their care instructions…only 20% of these patients perceived their own difficulties! (Engel et al., 2009). Topic familiarity and Kruger-Dunning effect may explain much of this.
- 4. COMMUNICATION MATTERS Effective communicationhas been associated with… Quicker, more accurate diagnoses Positive patient outcomes/survival Improved patient emotional health Improved satisfaction for patients and doctors both Reduced medico-legal risk
- 7. WHAT IS DESIGN-BASED RESEARCH? Diagram adapted from Springer.com for more information about DBR, see Wang and Hannafin, 2005.
- 8. 1. ALLOW FOR NOTICING “How many times did you get feedback during your GME?” “I only got feedback once.” Notice and try out in a supportive environment (Krashen).
- 9. II. NEED TO BE CONTEXTUALIZED AND MEANINGFUL Medical educator: The OBGYN resident didn’t know how to –and wouldn’t – describe a women’s last menstrual period. “What am I supposed to do with that?!” Literature suggests everyday patient speak is a major difficulty of IMGs.
- 10. III. NEEDS TO BE POSITIVE “People learn to avoid the things they are hit with” (Mager and Pipe) Avoid “extra” work Online Avoid humiliation; make it private Online “Most of the time I preferred not to talk…there was this sense of shame and ‘what if’.”
- 11. “WE HAVE BIGGER PROBLEMS.” “YOU WON’T MAKE ANY MONEY AT THAT.” Graphic from Knight, Emily. Indiana University School of Medicine "It can be argued that physicians are a much more efficient target of interventions than patients. After all, an intervention that changes a single physician's behavior is likely to affect thousands of patients each year. While is has long been assumed that physicians inevitably develop whatever communication skill they may need naturally or through experience, medial educators now agree training is necessary" (Roter, 2006, p. 176). Physicians communication more effectively Patients become better informed Patients have better outcomes Better outcomes for ALL
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