Objective Measures of Communication Behavior Predict Clinical Performance

Abstract

Objective: Effective teamwork and communication are critical to patient outcomes, and subjective assessment tools have been studied in predicting team performances. However, inherent biases remain while using subjective assessment tools. This study hypothesizes that objective communication features can assess and predict clinical performance.

Design: Forty 3rd-year medical students participated in the Acute Care Trauma Simulation as the role of doctor, teaming up with a nurse confederate and a simulated patient. Participants conducted postoperative patient management, patient care diagnoses, and treatment. Audio from all team members were recorded, speech variables (e.g., speech duration, number of conversations, etc.) were extracted, and statistical analyses were performed to associate communication with clinical performance.

Setting: This study was performed at the simulation center located at Fairbanks Hall, Indiana University School of Medicine.

Participants: Data from forty 3rd-year medical students were collected and analyzed.

Results: Majority (67%) of the communications were initiated by student. Speech ratio, intensity, and frequency of communications differed when students communicate with nurse than with patient (e.g., student communication to patient had higher intensity than nurse). Increasing frequency of check-backs between student and nurse (p < 0.05) and speech duration from student to patient (p = 0.001) positively associated with student's clinical performance score.

Conclusion: Objective communication features can predict medical trainee's clinical performance and provide an objective approach for simulation-based trauma care training.

Keywords: Interpersonal and Communication Skills; Patient Care; Professionalism; communication analysis; patient safety; team communication.