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New Test Improves Patient-Centered Care Among Physicians

Patient-centered care improves patient outcomes and satisfaction, research shows. As such, health care providers are increasing their focus on it. In fact, staff at the University of Missouri Health System developed an assessment tool to ensure medical school graduates are focused on this perspective.

To prepare the tool, researchers worked with real patients and identified a list of specific patient-centered behaviors over the course of several years. They then applied this list to a tailored educational experience at their MU School of Medicine to help medical students learn these skills. Results were published late last year in Medical Teacher, an international journal of education in the health sciences.

Assessment Focuses on Patient Interaction

The assessment, called the Patient-Centered Care – Objective Structured Clinical Exam, is delivered in students’ third year, a time when they are in the thick of clinical rotations and after they have completed classroom, lab, and simulation work.

“The test forces the future physician to go beyond just determining a diagnosis and to focus on behaviors that play an essential role to the effectiveness of the care he or she provides,” said Kimberly Hoffman, PhD, associate dean for curriculum and assessment and research associate professor of family and community medicine at MU.

“We developed very real, complex scenarios. The test uses standardized patients, standardized family members, and standardized health providers to simulate real-life situations,” she said. Students are tested on how they interact with patients, solicit information from them, and create a patient-centered care plan.

Results Indicate Strong Start, Room for Continuous Improvement

The researchers studying the assessment tool found the following to be true of most MU medical students:

  • strong, effective communication skills
  • didn’t use medical jargon
  • actively listened to the patient
  • showed empathy
  • were in charge of the situation when they needed to lead a critical conversation

After taking the exam, students receive detailed feedback – faculty comments and video – outlining positive and negative behaviors. For example, feedback includes the number of times students fold their arms, which suggests being guarded and closed off from the patient.

Faculty also have identified other opportunities within the assessment to help students improve, including examining barriers patients may face in sticking to the treatment plan. Moreover, the assessment “is prompting reflection among our faculty on their own medical practices, and how they may continually improve their own patient-centered care behaviors,” Hoffman said.

The assessment tool became part of MU medical students’ graduation requirements in 2012, and patient satisfaction scores are already rising. In 2013, 78 percent of patients at Missouri’s University Hospital said doctors always communicated well, up from a previous 68 percent. And other patient satisfaction scores rose even more, according to Kaiser Health News.


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