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1. Hello:
You are invited to participate in our survey Communication Methods in the Emergency Department. In this survey, approximately 500 people will be asked to complete a survey that asks questions about their preferred modes of communicating information to patients. It will take approximately 5-7 minutes to complete the questionnaire.

Your participation in this study is completely voluntary.

There are no immediate benefits to the subjects who participate in this study

There are no foreseeable risks associated with this project. However, if you feel uncomfortable answering any questions, you can choose to skip a question or withdraw from the survey at any point. It is very important for us to learn your opinions.

Your survey responses will be strictly confidential and anonymous and data from this research will be reported only in the aggregate. Your information will be coded and will remain confidential. If you have questions at any time about the survey or the procedures, you may contact Danielle McCarthy at 312-694-7000 or by email at the [email protected]. Questions about your rights as a research subject may be directed to Northwestern University’s Office for the Protection
of Research Subjects at telephone number 312-503-9338.


Thank you very much for your time and support. Please indicate your consent to participate in this survey by checking the "I Agree" box below and then start the survey by clicking on the Continue button below.

 
 
 
 
2. Gender?
 
Male
 
Female

 
 
 
3. Age?
   
 
 
 
4. Profession
 
Attending MD
 
Resident MD
 
Medical Student
 
RN
 
APN/NP/PA
 
ED Tech
 
Paramedic/EMT

 
 
 
5. What is the practice setting of your hospital?
 
Academic
 
Community

 
 
 
6. What is your specialty?
 
Emergency Medicine
 
Other
 

 
 
 
7. How many years (including training) have you been in practice?
   
 
 
 
8. What is the zip code of the hospital where you practice?
   
 
 
9. FOR EACH OF THE LINES BELOW, PLEASE ANSWER THE FOLLOWING QUESTIONS (SCALE OF 1-5)
.
Frequency: How often do use this communication technique with patients? 1=never...3=Sometimes....5=always Effectiveness: Please rate the effectiveness of this technique 1=ineffective...3=neutral...5=effective Feasibility in ED: Is this feasible to implement in your ED? 1=difficult...3=neutral...5=easy
Using simple language (avoid technical jargon)
Speaking more slowly
Reading aloud instructions
Presenting 2 or 3 concepts at a time and checking for understanding
Asking patient how they will follow instructions at home
Asking patients to repeat information, teach-back technique
Underlining key points in patient information handout
Using models or drawing pictures to explain
 
 
 
10. For the techniques you consider effective, but do not consider feasible in your practice, what are the barriers to implementing them? (Check all that apply)
 
Provider Time in writing paperwork
 
Provider Time in interacting with patients
 
ED Overcrowding
 
Supply Resources (eg no models or pictures to use)
 
Other

 
Communication Methods in the ED
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