‘Help! I need somebody’… Using Nominal Group Technique to develop a framework for medical students to use when seeking telephone advice from another health or social care professional in a simulated environment

Problem

Handover of clinical information is a vital part of healthcare, however is a high-risk activity which if undertaken poorly, can adversely impact on patient care. Whilst there are a variety of tools to aid clinical handover when transferring the care of a patient between clinicians, what is less established is the most appropriate structure to use when one clinician seeks advice from another but continues to have ongoing care responsibility for the patient. At Keele University, final year medical students undertake simulated consultations in a general practice setting in sessions called “Safe and Effective Clinical Outcomes.” During these sessions, students frequently need to call senior clinicians for advice. Informal discussion between supervising clinicians has shown that the quality of communication of information and clarity of questions during these calls is variable. Having a framework for medical students to follow when seeking telephone advice may improve this communication, in preparation for clinical practice.The aim of this study is to establish an understanding of what information senior clinicians feel a clinical advice call should include, then use this to create an educational framework for medical students to use when seeking telephone/verbal advice in simulated clinical settings.

Approach

Building on existing literature to introduce and contextualise the issue, we will use a modified Nominal Group Technique to gain consensus from a group of senior primary and secondary care clinicians about what information a telephone advice call from junior colleagues should contain. In this technique participants are involved in an iterative discussion process comprising systematic generation of ideas, ranking of these ideas in order of importance resulting in a mutually agreed list of core components which should be included in clinical advice calls. This will be used to generate a proposed tool to assist medical students undertaking this activity. This tool will be reviewed by the group and consensus will be deemed to be reached when no further adjustments are suggested.

Findings

This is currently a work in progress, Nominal Group meetings will be held in Spring and the results and proposed tool will be shared at the ASM.

Consequences

We hope that a new framework will enhance educational interventions to improve the quality of medical students’ advice calls to senior clinicians, and in doing so better prepare them to undertake this activity as doctors. This ultimately should result in better patient care. We would aim to pilot the use of this framework in the context of a simulated GP surgery and other clinical settings in a further study.