Spearheading Precision Education: Improving Communication in Medical Training

Updated on May 18, 2026 | Artificial Intelligence, Featured, OB/GYN, Primary Care, School

A recording device is being used to improve communication between medical residents and preceptors at Mount Sinai.

Precision medicine, which uses an individual patient’s genetic information to tailor treatment, has shown evidence of improving outcomes, particularly for those who don’t respond well to standard treatment. Mount Sinai educators are now exploring whether the same concept of precision can be applied to the way medical training is carried out, leading to improvements in learning efficiency.

Just as no two patients are the same, teachers and learners all differ in the way they teach, mentor, learn, and process information. A team of medical educators at the Icahn School of Medicine at Mount Sinai is developing a framework for “precision education,” leveraging artificial intelligence (AI) to establish evidence-based metrics for how mentors and trainees operate in a learning setting.

The project leverages new technologies, including AI analysis, to analyze the human-defined metrics of how patients, residents, and their attendings/preceptors communicate. A goal is to study communication patterns and explore whether certain approaches are associated with differences in patient engagement or care outcomes. Residents and their preceptors would then use these insights to try to adjust their communication styles to better match those of the people they are interacting with.

“Precision education is a relatively new concept—it started to be discussed in the post-COVID era—and in a sense, builds on the success of precision medicine,” says Deborah Edelman, MD, Associate Program Director of the Internal Medicine Residency, Mount Sinai Morningside-West.

Deborah Edelman, MD, Associate Program Director of the Internal Medicine Residency, Mount Sinai Morningside-West

“When people start residency, they don’t all start with the same levels of information, and they don’t all take the same journey to get to the end,” says Dr. Edelman. Almost all teaching programs—in medicine and other fields—aim to account for the middle of the bell curve. “Wouldn’t it be great if we can target all parts of the curve and help everyone maximize education?”

The framework that Dr. Edelman’s team is building is backed by a $1.1 million grant from the American Medical Association (AMA), which has tasked 11 institutions to develop precision education systems over four years. The grant program stems from AMA’s ChangeMedEd initiative, aimed at innovating medical education across the United States.

Linking communication styles to outcomes

Assessing the effectiveness of residency training starts with examining how feedback occurs. Currently, this is conducted with feedback forms.

“It works fine, but there are definitely areas for improvement,” says Dr. Edelman. “It can be biased—affected by whether a trainee likes the faculty member or not. The feedback is very subjective and variable, and if multiple suggestions conflict, it makes it hard for the faculty member to know what to change or improve.”

The team from the Icahn School of Medicine, as part of its AMA grant proposal, has designed a system that uses a recording device, such as a cell phone secured with HIPAA protections, to capture how residents interact with patients, and how residents discuss that patient interaction with their attending mentors.

That information is deidentified and parsed out by a large language model into structured variables relevant to the mentor, trainee, and patient. These could include:

  • Linguistic: talk time balance between parties, interruptions, word complexity, or sentence length
  • Patient outcomes: medication adherence, preventive care uptake, or visit adherence and continuity
  • Faculty assessment: Accreditation Council for Graduate Medical Education surveys, or narrative feedback
  • Demographic: race, gender, language preference, or socioeconomic status

“The idea is to gain actionable insights into how people communicate, and see how different combinations of variables are linked to patient outcomes,” says Dr. Edelman, who is also Associate Professor of Medicine (General Internal Medicine) at the Icahn School of Medicine. “When we have a collection of metrics, we can start to form phenotypes of how a person communicates, and from that point, it’s easier to see what works and what has room to improve.”

An overview of the Mount Sinai proposal for its precision education system, which uses ambient listening to improve communication skills (click here to view a larger image).

It’s important to highlight that the framework isn’t meant to cast judgment on any one communication style over others, notes Dr. Edelman. The framework is meant to demystify the process of communication by linking it to results, and to acknowledge the individual nature of each teacher, learner, or patient.

Scaling from Mount Sinai to nationwide

A pilot is underway to test the ambient listening system with Mount Sinai residents in OB/GYN and internal medicine programs. The pilot is born from a collaboration between the Departments of Artificial Intelligence and Human Health, Graduate Medical Education (GME), Digital and Technology Partners, and the various clinical departments at Mount Sinai to ensure patient information is handled safely and ethically.

“Our programs care for some of New York City’s most underserved populations, and we are committed to developing tools to advance health equity,” says Dr. Edelman.

Andrea Schecter, MD, Medical Director, Ambulatory Practices, Raquel and Jaime Gilinski Department of Obstetrics, Gynecology and Reproductive Science, Mount Sinai Health System (right), with Madeleine Reznik, MD, PGY-2 Internal Medicine resident, Mount Sinai Morningside and Mount Sinai West (left), trialing a precepting session with a recording device as part of the proposed precision education framework. As residents engage in their one-on-one sessions with their preceptors, their communication styles are recorded and analyzed by large language models.

Dr. Edelman (right) is in the process of assessing ideal recording setups for different interaction types, such as using an external microphone in a trial precepting session with Alexandria Still, MD, PGY-4 Internal Medicine and Chief Resident, Mount Sinai Morningside and Mount Sinai West (left), to improve recording quality.

A road map for the four years has been drawn out, with system development and testing in the first year. This will be followed by a staggered rollout and data collection in the second year, system refinement and data analysis in the third year, and scaling for dissemination to GME programs across the country in the final year.

“Precision education could be a big step for medical education, just as precision medicine has been for patients,” says Dr. Edelman. “Everybody wants to feel seen and heard. And when we have a system that is set up to listen to them and ties their communication to evidence-based metrics, nobody has their time wasted.”

What Can I Do About This Cough?

Updated on Jul 31, 2025 | Mount Sinai Doctors, Primary Care, Your Health

Coughs can take days or even weeks to go away. While a stubborn cough is annoying and sometimes even painful, it is your body’s natural way of clearing out harmful irritants and secretions—but that doesn’t mean you have to be uncomfortable or lose sleep.

In this Q&A, Jacqueline O’Boyle, DO, a primary care physician at Mount Sinai Doctors-Manhasset, explains what over-the-counter cough medicines and at-home remedies can help soothe your cough, and when it’s time to see a doctor.

Jacqueline O’Boyle, DO

What over-the-counter cough syrups do you recommend?

It depends on whether you have a dry cough or a wet cough. For most patients, I typically suggest guaifenesin (Mucinex®), which can help relieve both wet and dry coughs.

Wet coughs: These are caused by excess fluid or mucus in the airways, and are often caused by a post-nasal drip that tickles your throat. Treatments that dry up the nose and nasal passages are helpful. These include nasal steroid sprays, such as fluticasone (Flonase®) or mometasone (Nasonex®), which reduce inflammation. Antihistamines, which are anti-allergy drugs, are also good for drying up the nasal passages. Some popular over-the-counter antihistamines include loratadine (Alavert® and Claritin®) and fexofenadine (Allegra® Allergy, Aller-ease®, and Aller-Fex™).

Dry coughs: These don’t produce mucus. Remedies that stimulate saliva production and moisten the dry areas are very helpful. These include nasal saline sprays (Ayr® or Simply Saline™), lozenges, tea with honey and lemon, and humidifiers.

 

When should I see a doctor for my cough?

If you are experiencing any shortness of breath, tightness in your chest, persistent fever, cough up blood, or if your cough has gone on for more than three weeks or is causing chest pain, you should see a doctor. Most coughs are caused by viruses, which antibiotics don’t treat, but your doctor may prescribe an antibiotic if your cough is more likely bacterial. If your cough is interfering with sleep or your ability to function, there are certain medications that are effective, regardless of the cause of your cough. If you are immunocompromised, make sure to consult with your doctor.

Any chronic cough (that is, has been present for 8 weeks or more), requires evaluation by your doctor. 

 

What cough medications might the doctor prescribe?

Your doctor may prescribe you medications like benzonatate (Tessalon Perles®), which can both suppress your cough and allow you to sleep better. Benzonatate works well when used in combination with guaifenesin (Mucinex®). If you’re experiencing wheezing or tightness in your chest, or have a history of asthma, your doctor might prescribe inhaled steroids, or inhaled beta-2 adrenergic receptor agonists such as albuterol, or an oral steroid. If your cough is very disruptive, your doctor may prescribe a cough syrup with promethazine or codeine. While there is no evidence that cough syrup with promethazine or codeine will be more effective than placebo for people with cough from acute infection, some people find it allows them to sleep better and reduces symptoms.

 

What at-home remedies soothe a cough?

Good remedies for a dry cough are: lozenges, a spoonful of honey, or honey stirred into tea. Honey has been proven to reduce cough symptoms more so than most medications, and contains antibacterial properties (but never give honey to an infant younger than one year old.) There are a number of other at-home remedies to try. If you have a wet cough, elevating the head of your bed and using a humidifier can help. Elevating your head will prevent irritation from postnasal drip, and the humidifier will moisturize the air as well as your throat and sinuses, so you can sleep better at night. Rest, in turn, will help boost your immune system. Additionally, nasal irrigation rinses (such as NeilMed® Sinus Rinse or Neti Pot) can reduce swelling and flush out mucus (make sure to use only clean/sterile water).

 

Any other suggestions?

Sitting in a steamy bathroom with a hot shower running can help clear your nasal passages and throat. You can also try chest physical therapy, an airway clearance technique in which someone you know manually performs chest percussion on your chest wall to loosen mucous and phlegm. Strengthening your immune system with good nutrition, keeping yourself hydrated, and getting lots of rest are also important.

A cough can occur for reasons that are not related to infection.  If you have a cough, but no other signs of a cold or infection, see your doctor. It can be a symptom of acid reflux, asthma, COPD, or even a side effect from a medication.

If you smoke or vape, stop. Any respiratory irritant can worse cough and prolong recovery. 

 

Quick Tips:

  • Mucinex, a common over-the-counter medicine, is generally good at relieving any type of cough.
  • Treatments that dry up the airways (nasal steroid sprays and anti-allergy drugs) are ideal for treating wet coughs, whereas remedies that moisten the airways (nasal saline sprays, lozenges, humidifiers), help relieve dry coughs.
  • If you are having trouble sleeping, elevate the head of your bed (prevents post-nasal drip) and put a humidifier in your bedroom.
  • Never give medications to a child without consulting their pediatrician, or honey to a child under one year old.
  • See a doctor if you are experiencing shortness of breath, tightness or pain in your chest, persistent fever, or if your cough has gone on for more than three weeks. If you have health issues, do not take over-the-counter medications without consulting your doctor.

 

How can I soothe a child who is too young for cough medicine?

Never give children under the age of 12 cough medications unless instructed by the child’s doctor, as they are at a much greater risk of side effects. Never give a child under one year old honey, which can cause botulism. Instead, put a humidifier in their bedroom and elevate the top of their bed to keep their airways moist and to reduce the effects of post-nasal drip. If their cough is very bad, have them sit in a steamy bathroom with a hot shower running. If they are over one year old, you can give them half to one teaspoon of honey or over-the-counter remedies containing honey that are specifically made for children. Have them drink plenty of water to help flush out mucous and secretions. If your child is over three months old, consider using Vicks® BabyRub™. Unlike the adult version (Vicks VapoRub™), Vicks BabyRub does not contain camphor (dangerous if ingested), but uses holistic ingredients like aloe, eucalyptus, and lavender oil, which are safe for kids. You can rub it on their feet and chest. Be sure to consult your child’s doctor before putting them on Vicks BabyRub or other mediations, especially if they are under 12.

 

Are there cough medications that people with high blood pressure, or other health issues, should avoid?

Consult a doctor before taking any over-the-counter medications if you have health problems. For most people, dextromethorphan (Robitussin®), a common cough suppressant, is fine, but can cause dizziness, restlessness or drowsiness in some. Other cough medications, such as pseudoephedrine (Sudafed® or SudoGest™), can raise blood pressure and heart rate. Always read the labels of over-the-counter cough suppressants, as many should be taken with caution if you take other medications, such as the category of antidepressants known as SSRI/SNRIs (selective serotonin reuptake inhibitors/serotonin–norepinephrine reuptake inhibitor). A lot of them have multiple ingredients, so you want to make sure you’re not doubling up on any ingredients that could potentially harm you.

Find a primary care doctor to treat your cough.
Read more about Your Health.

I Think I Have a Sinus Infection. What Should I Do?

Oct 15, 2020 | Ear Nose Throat, Urgent Care, Your Health

Each year, nearly 30 million Americans are diagnosed with a sinus infection. Commonly referred to as “acute sinusitis,” sinus infections occur when inflammation of the lining of the nose and sinus cavities develop. As one of the most common illness in the country, they are a very frequent reason for patients to seek urgent medical care. In this Q & A, Catherine Spaulding, MD, a physician at Mount Sinai Urgent Care, explains how to identify a sinus infection and how best to treat your symptoms.  

How do I know if I have a sinus infection?

Look for the common symptoms such as a runny or congested nose, headaches, as well as pain and pressure in the sinuses — which are located above and below the eyes and on either side of the nose.

Frequently, sinus infections also cause a sore throat and coughing that is worse at night or the first thing in the morning. This is caused by post nasal drip and occurs when mucus drains down the back of the throat—most common when lying flat—resulting in  irritation of the throat, a scratchy or hoarse voice, and/or a cough.

Symptoms of a sinus infection typically last between three to ten days.

What causes acute sinusitis?

The large majority of cases of acute sinusitis are caused by viruses similar to those that cause the common cold. Inflammation of the sinuses from other triggers can also result in similar symptoms to that of a virus such as  environmental allergies, smoke, or dry air, as well as extreme changes in pressure that can occur when scuba diving or on an airplane. Additionally, patients with abnormal nasal anatomy, such as a deviated septum or nasal polyps, are at increased risk of developing an infection.

How do I tell the difference between COVID-19 and a sinus infection?

Distinguishing between COVID-19 and a sinus infection can be difficult since both can cause nasal congestion, a sore throat, headaches and sinus pain or pressure.  However, COVID-19 is more commonly associated with a fever, cough, body aches, chills, chest tightness, shortness of breath and occasionally with diarrhea. It is best to share all of your symptoms with your doctor to help determine if you should be tested for COVID-19.

Do I need to take antibiotics to get rid of my sinus infection?

Typically, no. While antibiotics are useful in treating bacterial infections, they are powerless against viruses. Taking antibiotics when they are not necessary or indicated can lead to resistant bacterial infections and unwanted medication side effects. Because of this, it is important to discuss whether an antibiotic is really needed when treating any infection.

Only around two percent of sinus infections are caused by bacteria. However, there are several instances in which your doctor might recommend antibiotics for treatment. This includes:

  • If your symptoms persist beyond 10 days without any improvement
  • If your illness worsens after day seven
  • If you have fevers with a temperature greater than 102 F at the start of symptoms
  • If you have a history of immunocompromising conditions—such as cancer, a history of an organ transplant, poorly controlled HIV or an immunodeficiency —or use of immunosuppressant medications—such as high doses of corticosteroids or  chemotherapy
  • If you have undergone sinus surgery
What should I take to treat my symptoms?

Like the common cold, most sinus infections will go away on their own. Treatment  should be aimed at relieving congestion in the nose and sinus passages. Doing so not only improves symptoms of the infection but reduces the possibility of developing a secondary bacterial infection. Here are some things to try at home:

  • Rinse your nasal passages with saline. Use a nasal saline rinse or spray twice daily to remove the mucus from the sinus cavities. This will allow you to breathe much easier.
  • Use a nasal steroid spray. After rinsing out your nose with saline, use a nasal steroid spray such as Fluticasone—one spray in each nostril twice daily— to reduce post nasal drip and congestion.
  • Try an over the counter decongestant. Medications such as pseudoephedrine provide additional help in relieving your stuffy, runny nose. But keep in mind that pseudoephedrine is a mild stimulant that can cause insomnia, so avoid taking right before bedtime. Additionally, it can raise your blood pressure so those with hypertension should not take this and should try Coricidin instead.
  • Use a bedside humidifier. Running a humidifier while you sleep can help to moisten the nasal passages and throat which will improve the flow of mucus by thinning it . If you do not have a humidifier, try taking a steam shower before bed for the same effect.
  • Take preventative measures. If you have a history of seasonal allergies, consider starting a daily antihistamine to prevent inflammation and mucus production.

If you suspect that you have a sinus infection and would like to speak with a doctor about your symptoms, schedule a walk in or virtual appointment with a Mount Sinai Urgent Care physician. 

View Mount Sinai Urgent Care Locations

How to Pick an Urgent Care Center

Oct 28, 2018 | Urgent Care, Your Health

There are many urgent care centers throughout New York, and they are not all the same. Mount Sinai’s approach to urgent care is unique. Joseph Feldman, MD, FACEP, Mount Sinai Urgent Care Medical Director, explains why that’s important for you.

What can I expect when I walk into a Mount Sinai urgent care center?

When you visit Mount Sinai Urgent Care you become part of the Mount Sinai family.  Our centers are an integral part of the Mount Sinai Health System, known for quality care and cutting-edge research.

What are the qualifications of the doctors?

You will be treated by board certified Emergency Medicine and Family Medicine physicians along with skilled nurse practitioners and physician assistants. All physicians have faculty appointments to the Icahn School of Medicine at Mount Sinai and often train residents and medical students in the latest urgent care practices.

Why is a connection to a medical school important?

Mount Sinai doctors and researchers are developing strategies that will help patients avoid unnecessary visits to the hospital emergency department (ED). ED visits for conditions that are not true emergencies can be expensive and detrimental to your health. Our urgent care centers play an important role in providing you the right care and have shorter wait times

 Can I really just walk in?

We welcome walk-ins. If you have an urgent medical need that is not a life-threatening emergency, just come into any of our locations throughout Manhattan and Brooklyn. You can also reserve a spot with our online scheduling system. We see patients of all ages, from infants to geriatrics, and we take all insurance plans including Fidelis and HealthFirst.

 What if I need further care?

We have priority access to primary care and specialty physicians of the Mount Sinai Health System, ensuring you can get easy referrals if you need additional care. Some of our urgent care centers even have multi-specialty practices within the same facility. Our urgent care centers are connected to the rest of the Mount Sinai Health System through electronic medical records, making it easy for physicians to communicate about your care.

What exactly do you treat at Mount Sinai Urgent Care?

We treat almost any immediate medical issue that’s not a life-threatening emergency, from sprains and broken bones to wounds and rashes. If you’re feeling symptoms of common illnesses like strep throat, flu, urinary tract infections, or sexually transmitted infections, we can confirm a diagnosis with a test and provide the medication you need. We offer a full array of vaccines and PPD testing for tuberculosis. We can also conduct physicals for school, work, workman’s compensation, and no-fault evaluations.

What kinds of diagnostic tools and imaging are available?

We do a full range of blood work and perform electrocardiograms. Our certified radiology technicians also provide full X-ray services. Some locations offer more advanced imaging, including CT scans and ultrasounds.

Learn more about Mount Sinai Urgent Care locations

Easier Access to Care at Mount Sinai Doctors Forest Hills

Updated on Jun 30, 2022 | Community, Primary Care

Above, from left: Steven Shayani, MD, Medical Director, Mount Sinai Doctors- Long Island Heart; Herbert S. Lempel, MD, Medical Director, Mount Sinai Doctors Forest Hills; Michael J. Robbins, MD, Mount Sinai Doctors Forest Hills, Cardiology; Benjamin S. Kornitzer, MD, Chief Medical Officer and Vice President, Mount Sinai Business Development; Brad Blumenfeld, Vice President, Blumenfeld Development Group; and Alicia Gresham, Vice President, Network Operations, Mount Sinai Health System.

Medical Assistant Marissa Reyes welcomed Marie D. Soffer to the practice.

Those who live and work in the Rego Park/ Forest Hills communities of Queens now have easier access to care with the recent opening of Mount Sinai Doctors Forest Hills. The nearly 16,500-square-foot facility brings together, under one roof, four existing Mount Sinai specialty practices from the area.

A ribbon-cutting and an open house last fall were celebratory events that attracted Mount Sinai leadership and physicians, city and local government officials, and the public. The facility offers specialists in primary care, cardiology, endocrinology, general and vascular surgery, neurology, obstetrics and gynecology, orthopedics, and urology. Radiology and lab services are also available onsite. Located at 99-01 Queens Boulevard between 66th Road and 67th Avenue, it is easily reached by city buses, and the M and R trains. For an appointment, call 718-520-6100.

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How Many Hours of Sleep Do You Need?

May 28, 2017 | Ask the Doc, Primary Care

“How many hours should you sleep a night? It’s a great question. The answer for most adults is somewhere between six and eight hours a night, but this is variable. Everyone knows someone who gets five hours a night and does perfectly fine. But most adults need between six and eight hours a night to be functional. And that’s the key: How functional are you? If you feel like you’re sleep deprived, you’re tired, you’re not functioning well, then it’s important to look at how you’re sleeping. What’s most important about sleep is maintaining a routine, something we call sleep hygiene, as best as you possibly can. So you want to try to avoid things that can disrupt your sleep cycle. What can disrupt your sleep cycle? Well, lots of caffeine late at night, which is a stimulant. Eating late at night can give you heartburn and wake you up. Certainly alcohol as we all know can give you a bad night’s sleep, as well. There are other medications which routinely interrupt your sleep cycles as well. So trying to maintain consistent habits – that’s really, really important. Anytime you start altering your habits, you alter your sleep cycle, and often times you’re not going to feel well-rested the next day. If you have any questions about your sleeping habits or you’re having difficulty with your sleep habits, by all means, please make an appointment with your primary care physician or with myself or any of my colleagues at Mount Sinai Doctors in Brooklyn Heights.”

David Coun, MD, is a board-certified primary care doctor and Chief of Internal Medicine at Mount Sinai Doctors Brooklyn Heights. He has lectured regularly on various topics, including smoking cessation, prostatic conditions, EKG review, and physician communication skills. Dr. Coun is fluent in Spanish and has a particular interest in prevention, as well as, the intersection between mental health and chronic medical conditions. Mount Sinai Doctors Brooklyn Heights is a two-floor practice with a walk-in urgent care center and more than 35 specialties. Located at 300 Cadman Plaza West, the practice is situated on the 17th and 18th floors.

Make an appointment with Dr. Coun
Make an appointment at Mount Sinai Brooklyn Heights