Communicating Clearly Across the Health Organization

A cornerstone of compassionate communication is the ability to make health information easy to understand and act on. Research shows that health professionals generally communicate in ways that are unnecessarily complex and confusing, which can undermine patients' confidence, trust, and agency for decision-making. Stress associated with illness, pain, or worry can make health information even harder to understand, remember, and act on. Commuinication training in health profession programs have begun to address this gap. The OHSU School of Medicine has been a leader in clear communication training.

The Doris and Mark Storms Chair in Compassionate Communication was established in 2018 to help expand our impact in communication education, with the goal of improving the effectiveness of health professionals, and the health care experiences and outcomes of patients, families, and caregivers. Health literacy and clear communication training has the greatest impact when implemented across health care systems. Discussing health or health-related topics with patients or caregivers occurs at all levels of an organization: discussing referrals for scheduling appointments, talking about insurance benefits and billing for services, triaging health care needs for urgency, routine wellness checks with nurses and medical assistants, and medical visits with physicians or other advanced practice providers. Each of these are an important and common step of obtaining medical care, and they each contribute to the overall health care experience. Providing all health care professionals with this training helps ensure that patients receive quality health care by meeting their communication needs. 

Communication in the Curriculum

Undergraduate Medical Education

A group of health care workers smile as they listen to a training.

Quality communication is critical to the delivery of safe, effective, and satisfying health services. Introducing communication training early in health professions education, and offering many learning opportunities throughout the educational experience, helps to develop foundational communication skills and reinforce them as communication habits during patient interactions. 

The OHSU School of Medicine's Professionalism, Ethics, and Communication curriculum focuses on teaching medical students these skills during the first 18 months of training. The curriculum uses an innovative 4 Habits for Patient-Centered Care model, which emphasizes relationship-building, agenda-setting, clear communication, and confirmation of understanding during every medical encounter. Students are taught these skills through a number of small group Clinical Skills Labs taught by multidisciplinary educators. 

Clear communication skills are assessed during simulated encounters, with actors playing the role of patients, during the pre-clinical period of training, and the required Family Medicine Core Clinical Experience rotation. OHSU was the first U.S. medical school to require students to pass a final assessment of compassionate communication skills during their 4th year Transition to Residency course in order to graduate. 

Graduate Medical Education

Formal training in the fundamentals of health literacy is an excellent addition to any medical residency or graduate health professional training program and can easily be integrated into didactic schedules. The OHSU Family Medicine residency programs is a prime example of a sustainable, longitudinal health literacy and clear communication curriculum. The residency offers a communication competency-guided curriculum for the 1st and 2nd year of residency, complete with assessments of communication skills during annual examinations of patient simulations. 

Curriculum Mapping

Dr. Coleman has completed the ambitious task of mapping the School of Medicine curriculum. This curriculum map focuses on required courses with learning objectives related to communication, professionalism, and ethics. This tool is used internally to help identify educational gaps in the curriculum. The curriculum map has been used to explore topics of substance use disorders, trauma-informed care, ageism, and disability and ableism.