To improve a resident’s communication skills with patients in the ambulatory clinic and inpatient settings.
1. Residents will be able to identify the components of the ILS model
2. Residents will be able to apply the ILS model to interactions with patients
The ILS model encourages residents to establish rapport with the patient (Invite), engage in active listening (Listen), and summarize the patient’s story throughout the interview (Summarize). These skills are part of a patient-centered interviewing technique that seeks to elicit the patient’s perspective. The authors of this model used standardized patients to provide feedback to learners on their ability to apply the model. This is a longitudinal curriculum and scenarios of graded difficulty are used throughout the year. Learners in small groups, working
with a standardized patient, are instructed to apply this model to the medical interview. Feedback from peers and standardized patients is used to improve communication skills.
A number of specialties could use this model in a variety of ways, depending on the resources of the program. This model is a more compressed version of the communications model developed by the Kalamazoo Consensus Statement.
Use of Standardized Patients:
Many academic medical centers have standardized patient programs and are happy to help construct specialty specific scenarios that reflect typical communication issues. The model could be presented in a short didactic form followed by resident interaction with a standardized patient who was instructed to give feedback regarding the resident’s application of this model. The advantage of this activity is that it provides residents with excellent feedback on their
interviewing skills. Standardized patients can also perform formative and summative assessment. Many standardized patient assessment centers have developed scenarios with high reliability and validity.
Role-play is another method that can be used to teach this model. A short didactic could be presented on the model. Ideally, one resident might take the role of the physician while one resident plays the role of the patient. The resident playing the patient could provide feedback to the “physician” on his/her ability to find it easier to do this activity if cases are chosen eforehand and are relevant to their specialty.
Videotaping and/or audiotaping allows the resident to self reflect on their communication style with a patient. Faculty review allows for significant discussion and formative feedback designed to improve a resident’s communication skills and enhance the development of an individualized learning plan. Residents and faculty should review the tape with an evaluation tool using
A fourth way to teach this model, which is fun for residents, is to present a short didactic on the model. Video clips of popular movies can be used to stimulate discussion about the model and about communication skills in general. For an extensive list of video clips, including discussion items, please see the resource guide section under Cinemeducation. For issues related to copyright, please consult this book as well.
Many of these strategies can be used to teach a variety of topics in Interpersonal and Communications Skills. Please see the bibliography at the end of this booklet for more excellent ideas.
Many of the assessment tools for patient-centered communication skills involve focused observation of the resident interacting with a patient. Program Directors should consider using a focused observation tool about twice a year. A focused observation tool allows faculty to identify a resident’s strengths and weaknesses in patient centered communication and helps residents develop a learning plan for improvement. There are many excellent focused observation tools, such as the Harvard Medical Schools Communication Skills Form or the SEGUE (see assessment section).