Food Insecurity: Physician Perspectives, Screening and Communication.

Introduction: Primary care physicians may perceive food insecurity (FI) as a difficult topic to address in health care encounters, resulting in at-risk patients not being identified. This exploratory study examines physician perspectives on how decisions to screen patients for FI are made, effective FI communication strategies, and barriers to screening. Methods: Primary care physicians in the statewide, practice-based Iowa Research Network (IRENE) completed a study survey in May 2022 that included structured and open-ended questions regarding their experiences screening for FI. Thematic and descriptive analysis identified common themes in providers' experiences and perspectives. Results: Although most physicians responding to the survey indicated that they have observed FI in their patient population, 27% have never observed FI in their practice. Physicians varied in their reasons for deciding to screen, with the most reported reason being "when it comes up in conversation." Common screening barriers among respondents included limited appointment time and feeling inadequately prepared to connect patients with resources. Respondents noted that negative experiences with FI screening were rare and noted positive experiences, including gratitude from the patient, and building patient-physician trust. Respondents shared normalizing phrases that helped address the additional obstacle of feeling inadequately prepared to assess FI in a tactful manner. Conclusions: This study explored physicians' experiences with asking patients about FI and provides insight into FI screening gaps, barriers, and opportunities. Better understanding of physician attitudes and practices may help guide and address barriers to more effective and consistent FI screening.

Family Medicine Clinician Screening and Barriers to Communication on Food Insecurity: A CERA General Membership Survey.

PURPOSE: Food insecurity (FI) is a hidden epidemic associated with worsening health outcomes affecting 33.8 million people in the US in 2021. Although studies demonstrate the importance of health care clinician assessment of a patient's food insecurity, little is known about whether Family Medicine clinicians (FMC) discuss FI with patients and what barriers influence their ability to communicate about FI. This study evaluated FM clinicians' food insecurity screening practices to evaluate screening disparities and identify barriers that influence the decision to communicate about FI. METHODS: Data were gathered and analyzed as part of the 2022 Council of Academic Family Medicine's Educational Research Alliance survey of Family Medicine general membership. RESULTS: The majority of respondents reported (66.9%) that their practice has a screening system for food insecurity, and most practices used a verbal screen with staff other than the clinician (41%) at specific visits (63.8%). Clinicians reported "rarely or never asking about FI" 40% of the time and only asking "always or frequently" 6.7% of the time. Inadequate time during appointments (44.5%) and other medical issues taking priority (29.4%) were identified as the most common barriers. The lack of resources available in the community was a significant barrier for clinicians who worked in rural areas. CONCLUSIONS: This survey provides insight into food insecurity screening disparities and identifies obstacles to FMC screening, such as time constraints, lack of resources, and knowledge of available resources. Understanding current communication practices could create opportunities for interventions to identify food insecurity and impact "Food as Medicine."

Communication skills in practice vs. communication in the real world: Insights from an international medical student symposium.

OBJECTIVE: To explore and compare medical students' experiences with communication skills training (CST) in medical education. METHOD: Five medical students from the U.S., U.K., and Ireland shared their experiences with CST at a 90-minute symposium held at the 2022 International Conference on Communication in Healthcare (ICCH). RESULTS: Students identified two areas of CST that may affect their preparedness for real-world clinical practice: 1) the impact of the COVID-19 pandemic on communication teaching and learning, and 2) the need to effectively communicate with diverse patient populations. CONCLUSION: The COVID-19 pandemic brought major changes to CST, and though training programs varied in their approach, students found that they were able to successfully adapt while gaining valuable skills needed to navigate communicating with patients on virtual platforms. When learning to communicate with patients from diverse backgrounds, students perceived generalized strategies that equipped them with the skills needed to adapt to uncertainty to be the most valuable. PRACTICE IMPLICATIONS: Collaboration between medical schools, both nationally and internationally, provides opportunity to share areas of strength and avenues for improvement in CST. Representation of learner perspectives is essential in order to better understand how well current educational methodologies prepare learners to enter real world clinical practice.