Abstract

Communicating with confused elderly patients: development and evaluation of an innovative teaching session for medical students

Author(s): Dr Muna Al-Jawad,Ms Jo Brown,Dr Jane Clatworthy,Ms Jo Brown

Clinical communication skills are an essential part of medical practice. It is widely accepted that teaching communication skills to health practitioners improves patient health outcomes. Approximately half of general hospital inpatients aged 65 or over have dementia, delirium or both. Communication with confused elderly patients may be challenging, however, it is possible and worthwhile. This article describes a new teaching session, with objectives to help medical students identify and use complex communication skills with confused, elderly patients. The session was developed according to the principles of constructivism and experiential learning. It used group discussion, analysis of video clips and tasks on the ward with feedback to develop skills. After piloting, it was evaluated with 146 medical students in the first, second and fourth year. A questionnaire was completed by students before and after the session. This included ratings of their confidence in aspects of communication with confused patients as well as qualitative analysis of their comments about the session and what had been learnt. Wilcoxon signed-rank test showed a significant increase in median confidence after the session. This increase was most marked in the fourth year medical students. Students’ comments showed that their learning had followed the objectives of the session and feedback was overwhelmingly positive. This is an important new approach to teaching about communication with confused, elderly patients and has the potential to be useful in teaching geriatric medicine in undergraduate, postgraduate and inter-disciplinary settings.