The 5Cs of Consultation: Training Medical Students to Communicate Effectively in the Emergency Department

J Emerg Med. 2015 Nov;49(5):713-21. doi: 10.1016/j.jemermed.2015.05.012. Epub 2015 Aug 4.


Background: Effective communication is critical for health care professionals, particularly in the Emergency Department (ED). However, currently, there is no standardized consultation model that is consistently practiced by physicians or used for training medical graduates. Recently, the 5Cs of Consultation model (Contact, Communicate, Core Question, Collaborate, and Close the Loop) has been studied in Emergency Medicine residents using simulated consultation scenarios.

Objective: Using an experimental design, we aimed to evaluate the efficacy of the 5Cs consultation model in a novel learner population (medical students) and in a "real time and real world" clinical setting.

Methods: A prospective, randomized, controlled study was conducted at eight large, academic, urban, tertiary-care medical centers (U.S. and Canada). Intervention involved two experimental groups (asynchronous and live training) compared to a baseline control group. All participants placed up to four consult phone calls. A senior physician observed and assessed each call using a preapproved 5Cs checklist and a Global Rating Scale (GRS).

Results: Participants who received training (asynchronous or live) scored significantly higher on the 5Cs checklist total and GRS than the control group. Both training methods (asynchronous and live) were equally effective. Importantly, learning gains were sustained as students' 5Cs checklist total and GRS scores remained consistently higher at their second, third, and fourth consult (relative to their first consult). At posttest, all participants reported feeling more confident and competent in relaying patient information.

Conclusion: Medical students can be trained to use the 5Cs model in a timely, inexpensive, and convenient manner and increase effectiveness of physician consultations originating from the ED.

Keywords: checklist; consultation; handoffs; medical education.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Checklist
  • Clinical Clerkship / methods*
  • Cooperative Behavior
  • Education, Medical, Undergraduate / methods*
  • Educational Measurement
  • Emergency Medicine / education*
  • Emergency Service, Hospital
  • Female
  • Humans
  • Interdisciplinary Communication*
  • Male
  • Models, Educational
  • Patient Simulation
  • Program Evaluation
  • Prospective Studies
  • Referral and Consultation*
  • Self Efficacy
  • Young Adult