American College of Chest Physicians

The American College of Chest Physicians (CHEST) is the leading professional association in innovative chest medicine. We advance the best health outcomes for patients with lung disease through education, advocacy, research, and philanthropy.

CHEST is the professional home for more than 20,000 pulmonary, critical care, and sleep medicine professionals seeking clinical education and connection to the worldwide chestmedicine community.

First 5 Minutes®

Through the First 5 Minutes program, clinicians learn evidence-based skills that are proven to help develop trust. The program’s e-learning and virtual reality modules offer strategies for quickly creating rapport with patients, responding to patient concerns with empathy, and building relationships. Expert faculty analyze videos of patient-clinician interactions and highlight where clinicians excelled and where there were missed opportunities. When implemented during the initial patient interaction, these purposeful changes in communication can greatly impact the relationship between the clinician and their patient.

It’s been shown that improved communication leads to greater patient adherence and, ultimately, time saved. Through establishing trust with patients earlier in the relationship, patient satisfaction, as well as patient outcomes, are expected to increase. Applicable to any clinician that sees patients, the First 5 Minutes program can have a major impact on the level of care provided. Why does this build trustworthiness? The First 5 Minutes program builds trust by equipping clinicians with evidence-based skills to establish rapport, respond empathetically, and prioritize patient concerns, leading to improved communication, adherence, satisfaction, and outcomes.

How It Works

Experience and patient feedback show that patients are more willing to embrace a treatment plan when they feel understood,which in turn leads to better long-term health outcomes. The First 5 Minutes e-learning modules demonstrate how the program can be utilized during the clinician’s initial conversation to:

Encourage the patient to share as many details as possible about not only their illness, but also about details of their lives that may impact their health, and
Increase trust in the clinician.

In the virtual reality modules, the clinicians will apply their empathetic listening and communication skills by conversing with a simulated patient.

Skills and Competencies

Reflect on implicit bias and turn assumptions into curiosity
Create rapport through small talk
Elicit a list of all patient concerns and prioritize
Negotiate an agenda for the visit while addressing their clinical goals
Explore the patient’s personal story
Respond with empathy through appropriate PEARLS statements (Partnership, Emotion, Apology/Appreciation, Respect, Legitimization, and Support)

Origins

During the fall of 2020, CHEST launched a listening tour in five areas of the United States that were experiencing disproportionate cases of, and deaths from, COVID-19. The purpose of the tour was to gain insights and identify solutions to combat health inequities among traditionally marginalized communities. A central theme that emerged was the importance that trust plays in the patient/clinician relationship. Barriers to the establishment of trust as expressed by patients related to:

Perceived dismissive attitudes among physicians
Lack of understanding and/or appreciation about social determinants of health
Overuse of highly technical/medical terminology that can be intimidating to patients
General cultural and philosophical differences that may contribute to implicit biases

The goal of this initiative was to create a comprehensive tool for building trust through empathetic medicine that can be widely implemented at institutions across the country.

Effectiveness

An intentionally designed program, the strategies selected for the First 5 Minutes program are proven in experience from the Academy of Communication in Healthcare, which was an integral partner in creating the program.

Scalability

Because the First 5 Minutes learning modules are virtual, this program can be largely implemented within institutions and private practices. The program will see the most success when rolled out through the healthcare entity as a part of the staff development curriculum.