Consequences of insecurity in emergency telephone consultations: an experimental study in medical students.

Barth, Jürgen; Ahrens, Regina; Schaufelberger, Mireille (2014). Consequences of insecurity in emergency telephone consultations: an experimental study in medical students. Swiss medical weekly, 144, w13919. EMH Schweizerischer Ärzteverlag 10.4414/smw.2014.13919

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QUESTION UNDER STUDY Handling emergency telephone consultations (ETCs) is a challenging and very important task for doctors. The aims of the study were to document insecurity in medical students during ETCs and to identify the reasons for that insecurity. We hypothesised that insecurity is associated with advising more urgent action (e.g. advice to call for an ambulance) in ETCs. METHODS We used ETCs with simulated patients (SPs), with each student randomly allocated two of four possible cases. After the training, 137 students reported on any insecurity that they had in the various ETC phases. We analysed the reasons for insecurity using descriptive statistics. The association between the students' advice that urgent action was needed and their insecurity was analysed with Spearman rank correlation. RESULTS Overall, 95% of the students felt insecure in at least one phase of their ETC. History taking was the phase in which students felt most insecure (63.1%), followed by the phase of analysing the information given by the patient (44.9%). Perceived insecurity was associated with more urgent advice in one case scenario (abdominal pain; correlation r = 0.46; p <0.01). The other two cases (child with fever; chest pain) also had a positive, but not statistically significant, correlation trend (p <0.12; p <0.08). CONCLUSIONS Insecurity is highly prevalent among medical students in their ETC decision-making. ETC training in medical schools, with a focus on structured history taking and formulating discriminating questions, might help decrease insecurity in ETCs. Medical education should also teach management of insecurity.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Medical Education > Institute of General Practice and Primary Care (BIHAM)
04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM)

UniBE Contributor:

Barth, Jürgen; Ahrens, Regina and Schaufelberger, Mireille


600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services




EMH Schweizerischer Ärzteverlag




Doris Kopp Heim

Date Deposited:

31 Jul 2014 10:23

Last Modified:

17 Mar 2016 09:26

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

emergency telephone consultations, simulated patients, insecurity, medical training




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