PROGRAM FOR INNOVATION IN CLINICAL EDUCATION
Communication with Consultants
Communication with consulting services can be a major source of frustration for EM trainees. The SBAR format still works here, but there are some best practices that we need to add to our paradigm: The 5C’s of Communicating with Consultants lay out the essential components of these conversations.
Close the Loop:
Who’s placing the consult (Name, Rank, Team)
Who’s being consulted (Name, Rank, Team)
State essential, accurate components of clinical situation
Provide a specific question or request of consultant
Agree on a reasonable timeframe for consultation
Be open to recommendations or changes in plan
Advocate for the patient if needed
Confirm recommendations or agreed upon timeframe
Thank the consultant
How you approach teaching and giving feedback on these conversations will obviously depend a lot on the learner. Junior learners such as interns and medical students may need to practice how the conversations will go before the consult order is placed. On the other hand, simply listening to the senior resident as she’s on the phone may be sufficient.
As you’re listening to and following consultation calls, identify whether or not residents adhered to best practices. Did they introduce themselves and identify the person they were speaking with? Was essential information omitted? Was the question or request clear? Do you have recommendations for navigating challenging consultations?
As you know, the ability to consult appropriately and efficiently is a life skill for emergency medicine. Your feedback and coaching helps our trainees develop good habits that lead to positive interactions with our colleagues on other services.
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Hern HG Jr., Gallahue FE, Burns BD, et al. Handoff Practices in Emergency Medicine: Are We Making Progress? Acad Emerg Med 2016;23(2):197–201.
Kessler CS, et al. The 5Cs of Consultation: Training Medical Students to Communicate Effectively in the Emergency Department. Journal of Emergency Medicine 2015;49(5):713–21.
Maughan BC, et al. ED handoffs: observed practices and communication errors. American Journal of Emergency Medicine 2011;29(5):502–11.