Facilitating effective communication through the adoption of SBAR tool in medical training

Abstract

Effective communication has been acknowledged as one of the most crucial elements to ensure the delivery of quality-assured healthcare services. The SBAR (Situation, Background, Assessment, and Recommendation) tool refers to a communication framework that has been widely employed in healthcare establishments to improve the clarity and efficiency of the exchange of information between healthcare professionals. The inclusion of the SBAR tool in medical education is expected to empower future cohorts of medical practitioners with the communication skills that are crucial in the delivery of safe, effective, and coordinated patient care. In conclusion, the SBAR tool has immense scope and potential to improve communication skills among medical students and thus we must adopt a comprehensive plan to overcome the potential challenges and ensure smooth implementation.

Introduction

Effective communication has been acknowledged as one of the most crucial elements to ensure the delivery of quality-assured healthcare services.[1] Effective communication plays a vital role in ensuring the transfer of accurate information and thereby reduces the probability of medical errors, and hence augments patient safety.[2] In-fact, once the patient understands their diagnoses, treatment options, and overall line of management, it is expected that patients will comply with the prescribed treatment, which will contribute towards improved patient outcomes.[3] In continuation, patients who get a feeling that they are being heard by doctors are more likely to be satisfied with the healthcare services offered to them.[4] From the healthcare system perspective, as professionals from different streams (like medicine, nursing, pharmacists, etc.) are involved in healthcare delivery, effective communication becomes crucial in improving collaboration between team members.[5] The purpose of the current article is to explore the utility of the SBAR tool in improving communication, identify the merits and the potential challenges, and the strategies to overcome these challenges to enable integration of the tool into the medical curriculum.

SBAR tool: A structured communication method

The SBAR (Situation, Background, Assessment, and Recommendation) tool refers to a communication framework that has been widely employed in healthcare establishments to improve the clarity and efficiency of the exchange of information between healthcare professionals, including medical students.[6,7] As this framework enables communication of all relevant information, it becomes easier for doctors to comprehend and respond promptly.[8] There are four key components of this tool, namely Situation (wherein the current condition or the health concern requires immediate attention), Background (provides detail about the context or history related to the situation of the patient), Assessment (Medical student summarizes the problems of patients.), and recommendation (Students should propose a line of management for the given patient.).[6,7,8]

This tool is quite easy to learn and use, and thus it becomes relatively feasible for all levels of healthcare professionals, right from students to experienced physicians.[7,9,10] In fact, owing to the simplicity of the format, there is a lesser probability of information being missed while communicating with the concerned person.[10] Moreover, the same tool can also be used across different healthcare disciplines (like doctor to nurse or pharmacist to nurse, etc.).[8] Another good quality of this tool is that it can be used in varied clinical settings (viz. emergency rooms, intensive care units, etc.) to facilitate effective communication between different stakeholders.[8,10,11]

Integration of SBAR in the medical curriculum

The inclusion of the SBAR tool in medical education is expected to empower future cohorts of medical practitioners with the communication skills that are crucial in the delivery of safe, effective, and coordinated patient care.[6,11] The process of integration of SBAR into the medical curriculum begins with a thorough needs assessment, wherein feedback from different stakeholders (viz. faculty, students, etc.) is obtained regarding the need to address improvement in communication skills.[12] Once this need is established, the next step is to clearly frame SBAR-related learning objectives, keeping in mind, the ways SBAR can improve and augment communication skill training.[6] Because the success of implementation of this tool will eventually depend on the readiness of faculty members, we must conduct faculty development programs to empower them about the tool and how it has to be used.[13] The curriculum committee of the institute can include SBAR training within the existing teaching schedule, and cover different aspects of the tool and its use for training medical students in the domain of communication skills, patient safety, and acquisition of clinical skills.[7,13]

Medical students can be trained in the SBAR tool with the help of different teaching-learning methodologies, namely didactic lectures, role-plays, simulation-based teaching, peer teaching, using case-based scenarios, and video demonstrations.[7,14,15] In addition, students can also be encouraged to reflect upon the exposure to the SBAR tool and thereby facilitate deep learning. It is quite essential that students must be assessed as well using the same tool to measure their extent of understanding about the tool, and this can be ascertained using objective structured clinical examinations, simulations, and interaction with real patients.[14,16] Moreover, students must be provided constructive feedback to improve their communication skills and become better clinicians.[16] Finally, the institute must plan for the evaluation of this intervention, and this can be accomplished through surveys, focus group discussions, etc., and based on the obtained results, desired modifications can be made.[17,18]

Merits of using SBAR

The introduction of the SBAR tool in medical training has been linked with an improvement in communication skills, as students learn the art of conveying critical information about patients effectively and concisely.[6,7] As the tool brings about a kind of standardization of information across different settings and different disciplines, there is a common understanding and collaboration among all members of the health team.[5,7] Further, owing to the accurate and efficient exchange of information, there is a reduction in the probability of communication-related errors, which in turn augments patient safety.[13,19] Moreover, the tool encourages critical thinking among healthcare professionals and thus there is an improvement in decision-making.[6] In addition, the tool brings about an improvement in the confidence level among students to effectively communicate even in emergencies.[8,11] Finally, the tool plays an important role in promoting professionalism and accountability among healthcare providers.[20]

Potential challenges in implementation

Like any other educational intervention, even concerning the SBAR tool, a wide range of challenges or concerns can become important bottlenecks. This begins with reluctance to change from teachers and/or students, as they might be comfortable with the conventional approaches.[7,13] In fact, inconsistent use of the tool across different departments or settings or scenarios can result in confusion among students.[6] Concerns can also be there with reference to training, wherein either students and/or teachers are not completely trained, which thereby interferes with deriving complete benefits. We must be careful regarding the possibility that communication styles and cultural attributes can interfere with the uniform adoption of the tool and thus there is a definite scope to not be rigid with the proposed framework.[13] Moreover, concerns have also emerged regarding assessing the effectiveness of the SBAR tool in improving communication, especially in busy clinical settings.[6,7]

Strategies to overcome identified challenges

Acknowledging the benefits that have been linked with the systematic adoption of SBAR tools, it is quite essential that we adopt a comprehensive plan to overcome the identified challenges.[6] This actually begins with promoting engagement of all stakeholders, which in turn can be accomplished by ensuring timely training/sensitization of these stakeholders to reduce the probability of resistance.[6,7] It is important to integrate SBAR across all courses and teaching departments uniformly to ensure that the tool is being consistently employed and adopted by teachers and medical students. It is a welcome strategy to adopt a wide range of teaching-learning methods to enable widespread training of students.[7,14,15] Further, students must be encouraged to use the tool in different settings, and they should be advised to be not too rigid with the framework, but rather be flexible according to the cultural or setting attribute. Moreover, it is a must that institutions must establish a mechanism to evaluate the effectiveness of this intervention to take appropriate measures to overcome the identified concerns.[17,18]

Conclusion

In conclusion, the SBAR tool has immense scope and potential to improve communication skills among medical students. Regardless of the merits that have been attributed to the tool in terms of improving patient outcomes, we must adopt a comprehensive plan to overcome the potential challenges and ensure smooth implementation.

Conflicts of interest

There are no conflicts of interest.

Funding Statement

Nil.