A Communication Curriculum for Obstetrics and Gynecology Residents: Applying the Principles of a “Goals of Care” Conversation

Abstract

OBJECTIVE: To develop an evidence-based communication training curriculum for obstetrics and gynecology residents using a “goals of care” framework and to develop the tools necessary to evaluate its effectiveness. METHODS: Following IRB approval, the baseline assessment examined: experience, comfort, concerns, and perceived barriers with conversations around serious illness; knowledge of communication skills; and a needs assessment. The existing and well-researched Vitaltalk curriculum for communicating in the setting of serious illness was adapted into a series of three 1-hour sessions including case scenarios relevant to Ob/Gyn practice. A postcourse evaluation assessed: self-reported comfort (retrospective) pre- and postintervention, knowledge of specific communication skills, and concerns and barriers regarding serious conversations. The curriculum and assessment tools were piloted in PGY-4 Ob/Gyn residents. EVALUATION: Eight PGY-4 residents participated in the pilot curriculum. All participants reported didactic training on delivering difficult news during medical school (1–10 hours). Thirty-eight percent of respondents reported ANY communication skills training in residency. Residents had poor baseline knowledge of communication skills (45% correct). Responding to patient emotion, addressing patient requests for unindicated treatment, and eliciting patient concerns about death and dying were the areas of greatest discomfort. Most (80%) participants found the training to be important to their development as an obstetrician/gynecologist. DISSEMINATION: Curricular materials and results of the pilot data will be submitted for publication on MedEdPORTAL. REFLECTIVE CRITIQUE: The value of a pilot study cannot be overstated. Moving forward, I will re-structure the didactic sessions, will not organize sessions by PGY class, and will streamline the assessment tools.