WIP 13 - Reading Level of Discharge Communication in the Emergency Department

Publication Number: WIP 13.7392

Sophia Lam, Maimonides Infants and Children's Hospital of Brooklyn, New York, NY, United States; Carl Preiksaitis, Stanford University School of Medicine, Palo Alto, CA, United States; Meigra Chin, Rutgers, Robert Wood Johnson Medical School, New Brunswick, NJ, United States; Kristen Adorno, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, United States; Ashley Panicker, Christiana Care Health System, Newark, DE, United States; Logan Weygandt, Johns Hopkins University School of Medicine, Baltimore, MD, United States

Background: Communication skills have been recognized as a core competency by the Accreditation Council for Graduate Medical Education since 1999. With regard to discharge instructions, prior research focused on the need for accessible discharge communication in the emergency department, both written and verbal, has demonstrated ongoing deficits in both patient understanding and physician skills for addressing gaps in comprehension. One national survey of emergency medicine residency programs found that over half of programs did not routinely evaluate residents on discharge proficiency. Based on guidelines from the American Medical Association, patient communication should be conducted at a 6th grade reading level to ensure patients with different learning backgrounds understand communications from physicians.

Objective: We aim to understand what reading level emergency physicians communicate at during a simulated patient discharge encounter, in order to determine the need for potential educational intervention to improve communication practice.

Design/Methods: Participants will be emergency medicine residents at four institutions throughout the country, recruited by e-mail during the 2023-2025 academic years. An online survey, administered via Qualtrics and IRB approved at all four institutions, will include a consent form and questions regarding demographic information, level of training, practice location, and perception of their communication level with patients. Participants will read two separate prompts describing an emergency department patient encounter and asking them to provide discharge counseling and instructions for the patient. They will record and upload a video of them speaking as if they were speaking to a patient, which will be stored in a secure online cloud storage system. Video recordings will be transcribed by the researcher and transcripts will be de-identified. Each transcript will be input into software that determines the reading level of the transcript. Descriptive statistics on survey data and reading level of the transcripts will be completed.