What are internal medicine residents missing? A communication needs assessment of outpatient clinical encounters

Patient Educ Couns. 2014 Sep;96(3):376-80. doi: 10.1016/j.pec.2014.07.015. Epub 2014 Jul 21.


Objective: In order to guide curricular innovation, we looked at the feasibility and utility of performing a targeted needs assessment of the communication skills of PGY2 internal medicine (IM) residents in their continuity clinic, utilizing faculty direct observation with a validated instrument for communication skills evaluation.

Methods: A convenience sample of PGY2 residents in the Emory University School of Medicine IM Residency Program was invited to participate. Using the SEGUE Framework, a checklist of medical communication tasks, faculty assessed residents during a clinic encounter.

Results: Thirty out of 53 (57%) PGY2 residents were assessed. SEGUE results indicate residents were most likely to "maintain patient's privacy" (100%), "greet patient appropriately" (97%) and "check/clarify information" (100%). Residents were least likely to "acknowledge waiting time" (7%), "explore psychosocial/emotional factors" (27%) and "outline agenda for visit" (33%).

Conclusion: The SEGUE Framework is a feasible tool to evaluate the communication skills of IM residents in a clinic setting. Many PGY2 IM residents in a large, urban practice do not elicit important psychosocial information during outpatient clinic visits.

Practice implications: More observation and evaluation of residents' communication skills are needed, with emphasis on building skills to "Understand the Patient's Perspective."

Keywords: Direct observation; Graduate medical education; Patient–doctor communication.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Clinical Competence
  • Communication*
  • Education, Medical, Graduate
  • Educational Measurement
  • Female
  • Georgia
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Internal Medicine / education*
  • Internship and Residency*
  • Male
  • Needs Assessment
  • Physicians
  • Pilot Projects
  • Surveys and Questionnaires