3323 ‘I’m worried I won’t truly understand how to help them’: medical students’ perceptions of communicating with confused patients

Abstract Introduction Hospital inpatients can present as confused for a multitude of reasons, thus learning how to effectively communicate with confused patients is a key skill for medical students. Fourth year is the first clinical year at our medical school. A verbal feedback session with fourth year medical student year representatives identified confidence in communicating with confused patients as a key concern of the cohort. Methods 40 fourth year medical students were surveyed using an online form. The students rated their confidence in communicating with confused patients on a Likert scale and were asked to explain this answer in under 100 words. These responses were collated into a Microsoft Excel Spreadsheet, and then thematic analysis using NVivo 12 software was applied to identify key themes. Results 20% (8/40) of students rated themselves as ‘very unconfident,’ 33% (13/40) as ‘somewhat unconfident,’ 38% (15/40) as ‘neither confident or unconfident,’ 7% (3/40) as ‘somewhat confident,’ and 2% (1/40) as ‘very confident.’ Key challenges identified by students included: unclear patient understanding or capacity (16 references), student communication style (15 references), patient distress or agitation (9 references), obtaining accurate information (7 references), and misunderstanding the patient (7 references). An e-learning resource including videoed simulated scenarios was created to attempt to address these challenges. 24 students who undertook the e-learning were surveyed at the end of the module. 4% (1/24) rated themselves as ‘neither confident or unconfident,’ 88% (21/24) as ‘somewhat confident,’ and 8% (2/24) as ‘very confident,’ with no students rating themselves as ‘very unconfident’ or ‘somewhat unconfident.’ Conclusion Medical students at the beginning of their clinical years lack confidence and identify several key challenges in communicating with confused patients. An understanding of these challenges is important for those working in Geriatric Medicine, particularly those involved in medical education. E-learning and utilising technology can be a helpful tool in developing students’ learning and confidence in this area.