Teaching Patient-Related Communication to Surgical Residents in Brief Training Sessions

J Surg Educ. 2020 Nov-Dec;77(6):1496-1502. doi: 10.1016/j.jsurg.2020.05.006. Epub 2020 Jun 11.

Abstract

Objective: Effective provider-patient communication has several benefits; however, few surgical residency programs have communication training and surgical residents have limited time for education. We developed a communication curriculum with limited didactics and emphasis on practice. Our objective was to evaluate whether this time-limited intervention led to changes in surgical resident communication skills.

Design: A 4-module curriculum was implemented for surgical residents (PGY2-4). Each 30-minute module focused on specific communication micro-skills: empathy, concerns and expectations, chunking information and avoiding jargon, and teach-back. Modules included brief didactics, simulated patient interactions, feedback, and debriefing. Precurriculum, residents completed a 2-station objective structured clinical examination (OSCE) and a survey on communication confidence. Residents evaluated each module and postcurriculum, completed another 2-station OSCE, confidence survey, and overall curriculum evaluation. Using validated rating scales, OSCEs were scored by 2 independent raters.

Setting: Tertiary care, academic center with a 5-year surgical residency program.

Participants: All 17 eligible residents completed both OSCEs and surveys, and 14 attended ≥3 modules.

Results: Following the curriculum, residents reported increased use of the targeted skills and increased confidence in responding to emotions, information sharing, and bad news telling (p < 0.004). There was no change in history taking. Residents rated the usefulness of each module modestly (2.5-3.1, scale 0-4), however, the likelihood of skill implementation was higher (3.2-3.6). The overall postcurriculum OSCE scores increased (versus precurriculum scores, p < 0.001). Postcurriculum scores increased for empathy, concerns and expectations, and teach-back. Chunking information and avoiding jargon was unchanged. Fifteen residents reported module length as appropriate, and 2 thought they were too short.

Conclusions: The brief modules led to increased self-reported use of communication skills and were effective in improving resident communication in OSCEs. This may be a useful curricular model for both surgical and nonsurgical residency programs with limited availability for curricular time.

Keywords: Interpersonal and Communication Skills; communication skills; communication training; curriculum development; physician-patient communication; surgery residents.

MeSH terms

  • Clinical Competence
  • Communication
  • Curriculum
  • Feedback
  • Humans
  • Internship and Residency*