Creating a new context for dialogue and reflection within a residency program: the development of a blog

Abstract

ABSTRACTWhile communication is essential to effective clinical outcomes and patient satisfaction, training programs that employ synchronous feedback systems are time consuming. This investigation employs the development and use of a secure blog as an asynchronous alternative for enhancing physician communication skills. Residents who participated in the communication training program for 2 years (N = 7) posted 63 responses to a blog hosting 13 doctor and patient interactions with an average post size of 322 words. Transcripts of the blog were analyzed using the constant comparative method. Themes were identified as they were associated with research questions. Residents’ concerns involved balancing information exchange and patient relationship development, with themes identified as lack of time, management of information, identification of an effective communication style, and managing distractions. The topics introduced in the blog involved strategies for addressing the narrative of the visit, the inclusion of patient concerns, communication style, and management of the EMR system. Finally, themes emerging from the discussion of patients included the patient as a distraction, the connection between rapport and compliance, and the patient as an obstacle to health maintenance. The blog is an innovative mechanism for resident feedback. The blog allows opportunity for learning through self-examination, reflection and it provides an opportunity for vicarious learning through peer modeling. The blog allows feedback between residents to be somewhat standardized in structure and occurrence and promotes interaction and the impetus to examine and critique each other outside the constraints of a real time feedback system.