Browsing by Author "Hobgood, Cherri D."
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Item Effect of an Educational Intervention on Medical Student Scripting and Patient Satisfaction: A Randomized Trial(eScholarship, 2018-05) Pettit, Katie E.; Turner, Joseph S.; Pollard, Katherine A.; Buente, Bryce B.; Humbert, Aloysius J.; Perkins, Anthony J.; Hobgood, Cherri D.; Kline, Jeffrey A.; Emergency Medicine, School of MedicineIntroduction: Effective communication between clinicians and patients has been shown to improve patient outcomes, reduce malpractice liability, and is now being tied to reimbursement. Use of a communication strategy known as "scripting" has been suggested to improve patient satisfaction in multiple hospital settings, but the frequency with which medical students use this strategy and whether this affects patient perception of medical student care is unknown. Our objective was to measure the use of targeted communication skills after an educational intervention as well as to further clarify the relationship between communication element usage and patient satisfaction. Methods: Medical students were block randomized into the control or intervention group. Those in the intervention group received refresher training in scripted communication. Those in the control group received no instruction or other intervention related to communication. Use of six explicit communication behaviors were recorded by trained study observers: 1) acknowledging the patient by name, 2) introducing themselves as medical students, 3) explaining their role in the patient's care, 4) explaining the care plan, 5) providing an estimated duration of time to be spent in the emergency department (ED), and 6) notifying the patient that another provider would also be seeing them. Patients then completed a survey regarding their satisfaction with the medical student encounter. Results: We observed 474 medical student-patient encounters in the ED (231 in the control group and 243 in the intervention group). We were unable to detect a statistically significant difference in communication element use between the intervention and control groups. One of the communication elements, explaining steps in the care plan, was positively associated with patient perception of the medical student's overall communication skills. Otherwise, there was no statistically significant association between element use and patient satisfaction. Conclusion: We were unable to demonstrate any improvement in student use of communication elements or in patient satisfaction after refresher training in scripted communication. Furthermore, there was little variation in patient satisfaction based on the use of scripted communication elements. Effective communication with patients in the ED is complicated and requires further investigation on how to provide this skill set.Item Effect of Socioeconomic Status Bias on Medical Student–Patient Interactions Using an Emergency Medicine Simulation(Wiley, 2017-04) Pettit, Katie E.; Turner, Joseph S.; Kindrat, Jason K.; Blythe, Gregory J.; Hasty, Greg E.; Perkins, Anthony J.; Ashburn-Nardo, Leslie; Milgrom, Lesley B.; Hobgood, Cherri D.; Cooper, Dylan D.; Emergency Medicine, School of MedicineObjectives Implicit bias in clinical decision making has been shown to contribute to healthcare disparities and results in negative patient outcomes. Our objective was to develop a high‐fidelity simulation model for assessing the effect of socioeconomic status (SES) on medical student (MS) patient care. Methods Teams of MSs were randomly assigned to participate in a high‐fidelity simulation of acute coronary syndrome. Cases were identical with the exception of patient SES, which alternated between a low‐SES homeless man and a high‐SES executive. Students were blinded to study objectives. Cases were recorded and scored by blinded independent raters using 24 dichotomous items in the following domains: 13 communication, six information gathering, and five clinical care. In addition, quantitative data were obtained on the number of times students performed the following patient actions: acknowledged patient by name, asked about pain, generally conversed, and touching the patient. Fisher's exact test was used to test for differences between dichotomous items. For continuous measures, group differences were tested using a mixed‐effects model with a random effect for case to account for multiple observations per case. Results Fifty‐eight teams participated in an equal number of high‐ and low‐SES cases. MSs asked about pain control more often (p = 0.04) in patients of high SES. MSs touched the low‐SES patient more frequently (p = 0.01). There were no statistically significant differences in clinical care or information gathering measures. Conclusions This study demonstrates more attention to pain control in patients with higher SES as well as a trend toward better communication. Despite the differences in interpersonal behavior, quantifiable differences in clinical care were not seen. These results may be limited by sample size, and larger cohorts will be required to identify the factors that contribute to SES bias.Item Emergency Medical Service, Nursing, and Physician Providers’ Perspectives on Delirium Identification and Management(Sage, 2017-04) LaMantia, Michael A.; Messina, Frank C.; Jhanji, Shola; Nazir, Arif; Maina, Mungai; McGuire, Siobhan; Hobgood, Cherri D.; Miller, Douglas K.; Medicine, School of MedicinePurpose of the study The study objective was to understand providers’ perceptions regarding identifying and treating older adults with delirium, a common complication of acute illness in persons with dementia, in the pre-hospital and emergency department environments. Design and methods The authors conducted structured focus group interviews with separate groups of emergency medical services staff, emergency nurses, and emergency physicians. Recordings of each session were transcribed, coded, and analyzed for themes with representative supporting quotations identified. Results Providers shared that the busy emergency department environment was the largest challenge to delirium recognition and treatment. When describing delirium, participants frequently detailed hyperactive features of delirium, rather than hypoactive features. Participants shared that they employed no clear diagnostic strategy for identifying the condition and that they used heterogeneous approaches to treat the condition. To improve care for older adults with delirium, emergency nurses identified the need for more training around the management of the condition. Emergency medical services providers identified the need for more support in managing agitated patients when in transport to the hospital and more guidance from emergency physicians on what information to collect from the patient’s home environment. Emergency physicians felt that delirium care would be improved if they could have baseline mental status data on their patients and if they had access to a simple, accurate diagnostic tool for the condition. Implications Emergency medical services providers, emergency nurses, and emergency physicians frequently encounter delirious patients, but do not employ clear diagnostic strategies for identifying the condition and have varying levels of comfort in managing the condition. Clear steps should be taken to improve delirium care in the emergency department including the development of mechanisms to communicate patients’ baseline mental status, the adoption of a systematized approach to recognizing delirium, and the institution of a standardized method to treat the condition when identified.Item Moving Beyond Gender Disparities: A Call to Action for Gender Parity and Equity(Elsevier, 2022) Jarman, Angela F.; Hobgood, Cherri D.; Madsen, Tracy E.; Emergency Medicine, School of MedicineItem Positive and Negative Influences on Female First Authorship Emergency Medicine Research(Wiley, 2019) Siddle, Jennica P.; Ryckman, Sydney N.; Hobgood, Cherri D.; Kline, Jeffrey A.; Emergency Medicine, School of Medicine