Flipped Exam Room

Journal of Medical Education and Curricular Development (12/24/20) Conway, Katharine; Hershberger, Paul J.; Bricker, Dean A.; et al.

The value of a "flipped exam room" approach to training medical students and residents in patient interaction skills is critical, as it should encourage patient engagement and increase the odds of positive patient outcomes. The flipped exam room model emphasizes motivational interviewing (MI) in a collaborative conversational manner for strengthening a person's own motivation and commitment to change. Another essential element is recognition of the difference between doctor work and patient work, with choices about recommended treatment options and decisions about whether a treatment or indicated behavior changes will be implemented examples of the latter. Patient engagement therefore involves liberal use of open-ended questions and reflective attention in order to identify the values, goals and priorities that truly matter to the patient. Recurrent exposure and sequenced learning are crucial for skill development, along with acceptance of the value of learning and practicing MI in the wider medical culture. There are opportunities for expanding MI training through online virtual platforms for role-play practice and student participation in telehealth visits. The authors suggest the flipped exam room could potentially meet all four requirements of the Quadruple Aim in healthcare: better outcomes, lower costs, patient satisfaction and physician well-being.

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