Evidence map›Paper›PMID 32273429›Full record

ArticleNeurology2020

Education Research: The medical student perspective on challenging conversations.

Rheaya Willis, Roy E Strowd, Mary C Barks, Rachel E Salas, Charlene E Gamaldo, Monica E Lemmon

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Neurology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Guideline
  2. Trial
  3. Article
  4. Article
  5. Article
  6. Review
  7. COVID-19 impact on neurology training program in Italy.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2021
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors.

Rheaya WillisFrom the Duke University School of Medicine (R.W.), Durham, NC; Department of Neurology (R.E. Strowd, R.E. Salas, C.E.G., M.E.L.), Johns Hopkins Medicine, Baltimore, MD; Department of Neurology (R.E. Strowd), Wake Forest School of Medicine, Winston-Salem, NC; Duke-Margolis Center for Health Policy (M.C.B., M.E.L.), Duke University; and Department of Pediatrics (M.E.L.), Duke University Medical Center, Durham, NC. Rheaya.willis@duke.edu.ORCID 0000-0002-4958-070X
Roy E StrowdFrom the Duke University School of Medicine (R.W.), Durham, NC; Department of Neurology (R.E. Strowd, R.E. Salas, C.E.G., M.E.L.), Johns Hopkins Medicine, Baltimore, MD; Department of Neurology (R.E. Strowd), Wake Forest School of Medicine, Winston-Salem, NC; Duke-Margolis Center for Health Policy (M.C.B., M.E.L.), Duke University; and Department of Pediatrics (M.E.L.), Duke University Medical Center, Durham, NC.
Mary C BarksFrom the Duke University School of Medicine (R.W.), Durham, NC; Department of Neurology (R.E. Strowd, R.E. Salas, C.E.G., M.E.L.), Johns Hopkins Medicine, Baltimore, MD; Department of Neurology (R.E. Strowd), Wake Forest School of Medicine, Winston-Salem, NC; Duke-Margolis Center for Health Policy (M.C.B., M.E.L.), Duke University; and Department of Pediatrics (M.E.L.), Duke University Medical Center, Durham, NC.
Rachel E SalasFrom the Duke University School of Medicine (R.W.), Durham, NC; Department of Neurology (R.E. Strowd, R.E. Salas, C.E.G., M.E.L.), Johns Hopkins Medicine, Baltimore, MD; Department of Neurology (R.E. Strowd), Wake Forest School of Medicine, Winston-Salem, NC; Duke-Margolis Center for Health Policy (M.C.B., M.E.L.), Duke University; and Department of Pediatrics (M.E.L.), Duke University Medical Center, Durham, NC.
Charlene E GamaldoFrom the Duke University School of Medicine (R.W.), Durham, NC; Department of Neurology (R.E. Strowd, R.E. Salas, C.E.G., M.E.L.), Johns Hopkins Medicine, Baltimore, MD; Department of Neurology (R.E. Strowd), Wake Forest School of Medicine, Winston-Salem, NC; Duke-Margolis Center for Health Policy (M.C.B., M.E.L.), Duke University; and Department of Pediatrics (M.E.L.), Duke University Medical Center, Durham, NC.
Monica E LemmonFrom the Duke University School of Medicine (R.W.), Durham, NC; Department of Neurology (R.E. Strowd, R.E. Salas, C.E.G., M.E.L.), Johns Hopkins Medicine, Baltimore, MD; Department of Neurology (R.E. Strowd), Wake Forest School of Medicine, Winston-Salem, NC; Duke-Margolis Center for Health Policy (M.C.B., M.E.L.), Duke University; and Department of Pediatrics (M.E.L.), Duke University Medical Center, Durham, NC.

Funding

Child Neurologist Career Development Program (CNCDP)K12NS098482 · NINDS · HUGO W. MOSER RES INST KENNEDY KRIEGER · PI SCHLAGGAR, BRADLEY L · 2016 to 2025
$26.2M
NINDS NIH HHS K12 NS098482
6 · The paper itself

Abstract

objectiveMedical students experience difficult conversations with patients during clinical clerkships. This study aimed to characterize barriers to and opportunities for learning in the setting of challenging conversations.

methodsNeurology clerkship medical students were enrolled prospectively in a concurrent nested mixed methods study. Qualitative data were collected using a postclerkship survey and semi-structured focus groups. Students were asked to reflect on challenging conversations they experienced with patients and to identify the top reasons why conversations were challenging. Responses were analyzed using directed content analysis.

resultsA total of 159 medical students were enrolled (MS2: n = 35 [22%]; MS3: n = 97 [61%]; MS4: n = 27 [17%]). Three themes of difficulty were identified in survey and focus group data: (1) tough clinical realities: how the clinical environment makes conversations challenging; (2) communication skill needs: the difficulty of finding the words to say; and (3) navigating emotions: of patients, clinicians, and students themselves. Tough clinical realities were cited by over two-thirds of students in all years (MS2: n = 30 [86%]; MS3: n = 74 [76%]; MS4: n = 23 [85%]). Communication skills needs were cited most frequently by third-year students (MS2: n = 15 [43%]; MS3: n = 55 [57%]; MS4: n = 10 [37%]). Students early in training were more likely to cite difficulty navigating emotions (MS2: n = 28 [80%]; MS3: n = 71 [73%]; MS4: n = 19 [70%]).

conclusionsMedical students frequently observe and participate in challenging conversations with patients. Here, students identified what makes these conversations most difficult. Communication curricula should leverage clinical communication encounters, prepare students for inherent clinical realities, and help students navigate emotions in the health care setting.

Indexed as

CommunicationNeurologyPhysician-Patient RelationsStudents, MedicalEducation, Medical, UndergraduateHumans

Identifiers

PMID32273429
PMCPMC7455339

What OpenQuestion holds

Textmetadata
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.