Administration of Emergency Medicine SELF-REPORTED USE OF COMMUNICATION TECHNIQUES IN THE EMERGENCY DEPARTMENT Danielle M. McCarthy, MD,* Kenzie A. Cameron, PHD, MPH,†‡ D. Mark Courtney, MD,* and John A. Vozenilek, MD* *Department of Emergency Medicine, †Division of General Internal Medicine, Northwestern University Feinberg School of Medicine, and ‡Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, Illinois Reprint Address: Danielle M. McCarthy, MD, Department of Emergency Medicine, Northwestern University Feinberg School of Medicine, 211 E. Ontario Street, Suite 200, Chicago, IL 60611 , Abstract—Background: Communication is considered a core competency for physicians. However, the Emergency Department setting poses significant and unique communi- cation challenges. Objective: The objective of this study was to explore self-reported use and perceptions of effective- ness and feasibility of communication techniques used by Emergency Physicians for communication with patients. Methods: This cross-sectional study utilized a previously published survey on eight communication techniques. Re- spondents were asked to quantify their personal use and per- ceptions of effectiveness and feasibility of each technique. Responses were analyzed for differences based on practice setting (community, academic) and provider role (attending, resident). The survey was administered to a convenience sample recruited at the national meeting of the American College of Emergency Physicians. Results: One hundred and sixty-nine participants were enrolled (70.5% male; 55.8% attending physicians, 44.2% residents; 66.2% prac- ticed in academic settings). Using simple language and speaking slowly to patients were the only techniques identi- fied as being used routinely by a majority of the sample (92.2% and 61.3%, respectively). A majority of the sample ranked seven of the techniques as effective; all techniques were considered feasible in the Emergency Department. No differences were noted across provider role or practice setting. Conclusion: The majority of respondents are not uti- lizing communication techniques, despite their own beliefs that the techniques are effective and easy to implement in the Emergency Department. Additional research is needed to determine the effectiveness of these techniques and rele- vant barriers to their use. Ó 2012 Elsevier Inc. , Keywords—verbal communication; teach back; health literacy INTRODUCTION According to the Institute of Medicine, >90 million Americans have difficulty understanding health informa- tion (1). Previous research has established a strong relationship between low literacy and poor health out- comes (2–6). Understanding how care providers are communicating new information to patients and how this communication can be improved is critical. The Accreditation Council for Graduate Medical Edu- cation, the American Board of Medical Specialties, and the Joint Commission have established communication as a core competency for physicians (7–9). Although many providers are aware of communication techniques and believe that they are effective, this awareness has not translated into high rates of use (10). Furthermore, many efforts at improving communication with patients Presented at the Academy Health Annual Research Meeting, June 2011, Seattle, WA and the International Conference for Communication in Healthcare, October 2011, Chicago, IL. RECEIVED: 30 June 2011; FINAL SUBMISSION RECEIVED: 30 September 2011; ACCEPTED: 13 February 2012 e355 The Journal of Emergency Medicine, Vol. 43, No. 5, pp. e355–e361, 2012 Copyright Ó 2012 Elsevier Inc. Printed in the USA. All rights reserved 0736-4679/$ - see front matter doi:10.1016/j.jemermed.2012.02.033