"What Questions Do You Have?": Teaching Medical Students to Use an Open-Ended Phrase for Eliciting Patients'...

Area of Science:

• Medical Education
• Health Communication
• Patient-Centered Care

Background:

• Patients often struggle to understand health information, leading to low question-asking rates, especially among those with lower health literacy.
• Effective communication strategies, like using open-ended questions, are recommended to encourage patient inquiry.
• Existing didactic curricula may not sufficiently instill long-term communication habits.

Purpose of the Study:

• To compare the effectiveness of a didactic health literacy curriculum versus a longitudinal problem-based communication curriculum on medical students' question-eliciting techniques.
• To assess whether students spontaneously attempt to elicit patient questions and the types of phrases they use.

Main Methods:

• Video-recorded, observed structured clinical examinations were used to evaluate communication skills.
• Medical students (n=46 didactic, n=32 longitudinal) were assessed without their knowledge of specific observation focus.
• Question-eliciting behaviors, including spontaneous attempts and phrase type (open-ended vs. closed-ended), were analyzed.

Main Results:

• Students in the longitudinal intervention group were more likely to spontaneously attempt to elicit questions (84.4% vs. 65.2%).
• The intervention group significantly favored using open-ended eliciting phrases (51.9% vs. 6.7%).
• The longitudinal curriculum demonstrated success in establishing lasting patient-centered question-eliciting habits.

Conclusions:

• A longitudinal, problem-based communication curriculum is more effective than a didactic approach in developing patient-centered question-eliciting skills in medical students.
• This training fosters long-term habits of using open-ended questions to encourage patient engagement.
• Further research should explore the impact of these techniques on the number and type of patient clarifying questions.