Amber W Trickey1, Anna B Newcomb2, Melissa Porrey2, Franco Piscitani3, Jeffrey Wright3, Paula Graling3, Jonathan Dort3. 1. Advanced Surgical Technology and Education Center, Department of Surgery, Inova Fairfax Hospital, Falls Church, Virginia; Stanford-Surgery Policy Improvement Research and Education Center, Department of Surgery, Stanford University, Stanford, California. Electronic address: atrickey@stanford.edu. 2. Division of Trauma, Department of Surgery, Inova Fairfax Hospital, Falls Church, Virginia. 3. Advanced Surgical Technology and Education Center, Department of Surgery, Inova Fairfax Hospital, Falls Church, Virginia.
Abstract
OBJECTIVES: Surgery milestones from The Accreditation Council for Graduate Medical Education have encouraged a focus on training and assessment of residents' nontechnical skills, including communication. We describe our 2-year experience implementing a simulation-based curriculum, results of annual communication performance assessments, and resident evaluations. DESIGN: Eight quarterly modules were conducted on various communication topics. Former patient volunteers served as simulation participants (SP) who completed annual assessments using the Communication Assessment Tool (CAT). During these 2 modules, communication skills were assessed in the following standardized scenarios: (1) delivering bad news to a caregiver of a patient with postoperative intracerebral hemorrhage and (2) primary care gallstone referral with contraindications for cholecystectomy. SP-CAT ratings were evaluated for correlations by individual and associations with trainee and SP characteristics. Surgical patient experience surveys are evaluated during the curriculum. SETTING: Independent academic medical center surgical simulation center. PARTICIPANTS: Twenty-five surgery residents per year in 2015 to 2017. RESULTS: Residents have practiced skills in a variety of scenarios including bad news delivery, medical error disclosure, empathic communication, and end-of-life conversations. Residents report positive learning experiences from the curriculum (90% graded all modules A/A+). Confidence ratings rose following each module (p < 0.001) and in the second year (p < 0.001). Annual assessments yielded insights into skills level, and relationships to resident confidence levels and traits. Communication scores were not associated with resident gender or postgraduate year. Over the course of the curriculum implementation, surgical patients have reported that doctors provided explanations with improved clarity (p = 0.042). CONCLUSIONS: The simulation-based SP-CAT has shown initial evidence of usability, content validity, relationships to observed communication behaviors and residents' skills confidence. Evaluations of different scenarios may not be correlated for individuals over time. The communication curriculum paralleled improvements in patient experience concerning surgeons' clear explanations. An ongoing surgery resident communication curriculum has numerous educational, assessment, and institutional benefits.
OBJECTIVES: Surgery milestones from The Accreditation Council for Graduate Medical Education have encouraged a focus on training and assessment of residents' nontechnical skills, including communication. We describe our 2-year experience implementing a simulation-based curriculum, results of annual communication performance assessments, and resident evaluations. DESIGN: Eight quarterly modules were conducted on various communication topics. Former patient volunteers served as simulation participants (SP) who completed annual assessments using the Communication Assessment Tool (CAT). During these 2 modules, communication skills were assessed in the following standardized scenarios: (1) delivering bad news to a caregiver of a patient with postoperative intracerebral hemorrhage and (2) primary care gallstone referral with contraindications for cholecystectomy. SP-CAT ratings were evaluated for correlations by individual and associations with trainee and SP characteristics. Surgical patient experience surveys are evaluated during the curriculum. SETTING: Independent academic medical center surgical simulation center. PARTICIPANTS: Twenty-five surgery residents per year in 2015 to 2017. RESULTS: Residents have practiced skills in a variety of scenarios including bad news delivery, medical error disclosure, empathic communication, and end-of-life conversations. Residents report positive learning experiences from the curriculum (90% graded all modules A/A+). Confidence ratings rose following each module (p < 0.001) and in the second year (p < 0.001). Annual assessments yielded insights into skills level, and relationships to resident confidence levels and traits. Communication scores were not associated with resident gender or postgraduate year. Over the course of the curriculum implementation, surgical patients have reported that doctors provided explanations with improved clarity (p = 0.042). CONCLUSIONS: The simulation-based SP-CAT has shown initial evidence of usability, content validity, relationships to observed communication behaviors and residents' skills confidence. Evaluations of different scenarios may not be correlated for individuals over time. The communication curriculum paralleled improvements in patient experience concerning surgeons' clear explanations. An ongoing surgery resident communication curriculum has numerous educational, assessment, and institutional benefits.
Keywords:
Interpersonal and Communication Skills; Professionalism; curriculum; educational measurement; health communication; simulation training; truth disclosure
Authors: Hamna Shahbaz; Ali Aahil Noorali; Maha Inam; Namra Qadeer; Asma Altaf Hussain Merchant; Adnan Ali Khan; Noreen Afzal; Komal Abdul Rahim; Ibrahim Munaf; Rida Ahmad; Muhammad Tariq; Adil H Haider Journal: BMJ Open Date: 2022-08-18 Impact factor: 3.006