TY - JOUR
T1 - Prognosis communication with older patients with multimorbidity
T2 - Assessment after an educational intervention
AU - Schoenborn, Nancy L.
AU - Cayea, Danelle
AU - McNabney, Matthew
AU - Ray, Anushree
AU - Boyd, Cynthia
N1 - Funding Information:
This project was made possible with a grant from the Arnold P. Gold Foundation (The Picker Institute/Gold Foundation Graduate Medical Education Challenge Grant); it was also supported by The John A. Hartford Foundation Geriatric Center of Excellence. Dr. Schoenborn was supported by the Donald W. Reynolds Consortium Faculty Development to Advance Geriatric Education Program: Next Steps and the Daniel and Jeannette Hendin Schapiro Geriatric Medical Education Center. Dr. Boyd was supported by the Paul Beeson Career Development Award (NIA K23 AG032910), the John A. Hartford Foundation, Atlantic Philanthropies, and the Starr Foundation. Dr. McNabney was supported by the Fellowship Training Program in Geriatric Medicine and Gerontology at Johns Hopkins, and Dr. Cayea was supported by the Daniel and Jeannette Hendin Schapiro Geriatric Medical Education Center. Ms. Ray was working as research assistant during this project at the Johns Hopkins School of Medicine but has since moved. She currently works as project manager at Medline Industries. This project was made possible with a grant from the Arnold P. Gold Foundation (The Picker Institute/Gold Foundation Graduate Medical Education Challenge Grant); it was also supported by The John A. Hartford Foundation Geriatric Center of Excellence. Dr. Schoenborn was supported by the Donald W. Reynolds Consortium Faculty Development to Advance Geriatric Education Program: Next Steps and the Daniel and Jeannette Hendin Schapiro Geriatric Medical Education Center. Dr. Boyd was supported by the Paul Beeson Career Development Award (NIA K23 AG032910), the John A. Hartford Foundation, Atlantic Philanthropies, and the Starr Foundation. Dr. McNabney was supported by the Fellowship Training Program in Geriatric Medicine and Gerontology at Johns Hopkins, and Dr. Cayea was supported by the Daniel and Jeannette Hendin Schapiro Geriatric Medical Education Center.
Publisher Copyright:
© 2016 Taylor & Francis.
PY - 2017/10/2
Y1 - 2017/10/2
N2 - This study aimed to assess how internal medicine residents incorporated prognosis to inform clinical decisions and communicated prognosis in primary care visits with older patients with multimorbidity after an educational intervention, and resident and patient perspectives regarding these visits. Assessment used mixed-methods. The authors assessed the frequency and content of prognosis discussions through residents’ self-report and qualitative content analysis of audio-recorded clinic visits. The authors assessed the residents’ perceived effect of incorporating prognosis on patient care and patient relationship through a resident survey. The authors assessed the patients’ perceived quality of communication and trust in physicians through a patient survey. The study included 21 clinic visits that involved 12 first-year residents and 21 patients. Residents reported incorporating patients’ prognoses to inform clinical decisions in 13/21 visits and perceived positive effects on patient care (in 11/13 visits) and patient relationship (in 7/13 visits). Prognosis communication occurred in 9/21 visits by self-report, but only in six of these nine visits by content analysis of audio-recordings. Patient ratings were high regardless of whether or not prognosis was communicated. In summary, after training, residents often incorporated patients’ prognoses to inform clinical decisions, but sometimes did so without communicating prognosis to the patients. Residents and patients reported positive perceptions regarding the visits.
AB - This study aimed to assess how internal medicine residents incorporated prognosis to inform clinical decisions and communicated prognosis in primary care visits with older patients with multimorbidity after an educational intervention, and resident and patient perspectives regarding these visits. Assessment used mixed-methods. The authors assessed the frequency and content of prognosis discussions through residents’ self-report and qualitative content analysis of audio-recorded clinic visits. The authors assessed the residents’ perceived effect of incorporating prognosis on patient care and patient relationship through a resident survey. The authors assessed the patients’ perceived quality of communication and trust in physicians through a patient survey. The study included 21 clinic visits that involved 12 first-year residents and 21 patients. Residents reported incorporating patients’ prognoses to inform clinical decisions in 13/21 visits and perceived positive effects on patient care (in 11/13 visits) and patient relationship (in 7/13 visits). Prognosis communication occurred in 9/21 visits by self-report, but only in six of these nine visits by content analysis of audio-recordings. Patient ratings were high regardless of whether or not prognosis was communicated. In summary, after training, residents often incorporated patients’ prognoses to inform clinical decisions, but sometimes did so without communicating prognosis to the patients. Residents and patients reported positive perceptions regarding the visits.
KW - Curriculum assessment
KW - multimorbidity
KW - older adults
KW - prognosis communication
KW - resident education
UR - http://www.scopus.com/inward/record.url?scp=84981717378&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84981717378&partnerID=8YFLogxK
U2 - 10.1080/02701960.2015.1115983
DO - 10.1080/02701960.2015.1115983
M3 - Article
C2 - 26885757
AN - SCOPUS:84981717378
SN - 0270-1960
VL - 38
SP - 471
EP - 481
JO - Gerontology and Geriatrics Education
JF - Gerontology and Geriatrics Education
IS - 4
ER -