Pilot Study for Assessing Nontechnical Skills in Emergency Medicine Residents: Why We Should C.A.R.E

Area of Science:

• Medical Education
• Patient Experience Research
• Emergency Medicine

Background:

• Increasing focus on patient experience and satisfaction in healthcare settings.
• Limited data on emergency medicine residents' nontechnical skills in patient interactions.
• Need for effective evaluation tools for physician communication and situational awareness.

Purpose of the Study:

• To evaluate a nontechnical skills rating tool for emergency medicine residents.
• To assess residents' performance in patient interactions using the C.A.R.E. framework.
• To identify areas for improvement in residents' nontechnical skills.

Main Methods:

• Utilized a hospitality training company to develop and implement an observational tool.
• Assessed nontechnical skills in four domains: Connect, Adjust, Resolve, Empathize (C.A.R.E.).
• Faculty rated residents' interactions with patients on a binary scale (acceptable/unacceptable).

Main Results:

• Residents performed well in empathy, adjusting to patient needs, and resolving requests.
• Communication skills, including establishing rapport and appropriate address, were rated unacceptable in 31% of interactions.
• Performance was assessed across 34 of 36 residents.

Conclusions:

• Emergency medicine residents demonstrate proficiency in most observed nontechnical skills.
• Communication remains a key area for development, even when residents are aware of observation.
• Interventions targeting communication skills can significantly improve patient interactions and satisfaction.