Abstract
BackgroundTo ensure optimal patient care, physicians must establish effective patient-physician relationships and thoughtfully incorporate their patients’ perspectives into their counseling. Historically, these skills are acquired with increasing clinical experience. However, given increasing work-hour restrictions, OB/GYN residents have fewer opportunities to develop these skills. Therefore, the objective of this study was to determine if an interactive learning method is an effective tool by which to teach OB/GYN residents how to communicate with complicated patients.MethodsAn experiential simulation model was developed to teach OB/GYN residents effective communication skills for dealing with patients experiencing a pregnancy-related complication. A simulated patient interaction was designed for first-year residents. Specific scenarios were constructed based on challenging clinical scenarios identified by second-year residents. Non-judgmental communication, culture competency awareness and reflective listening were key skills that were taught as part of the clinical scenarios. Both acceptability and utility of the exercise with the first-years was assessed by a follow-up survey.ResultsSeven first-year residents participated in the education session consisting of four physician-patient interactions with specific learning objectives for each. These first-year residents all indicated that they would employ the skills practiced during the intervention into their future practice of medicine, and that their comfort level in caring for complex obstetric patients had increased. Moreover, all first-year residents endorsed that this educational strategy was potentially applicable to other aspects of their training.ConclusionsSimulated patient exercises can be utilized in multiple arenas to teach OB/GYN residents communication skills, while simultaneously addressing their clinical knowledge deficits. Early implementation of such a curriculum in an OB/GYN residency will lay the foundation for the development of empathetic and culturally competent physicians.
Highlights
To ensure optimal patient care, physicians must establish effective patient-physician relationships and thoughtfully incorporate their patients’ perspectives into their counseling
A recent survey of physician-educators in obstetrics and gynecology (OB/ GYN) by Espey et al reported concerns regarding the negative impact of resident work hours on resident education [2]
63% of the respondents felt that the global education of an obstetrics and gynecology resident was worse, as compared to what it had been prior to the implementation of work hour requirements by the Accreditation Council of Graduate Medical Education (ACGME) [2]
Summary
To ensure optimal patient care, physicians must establish effective patient-physician relationships and thoughtfully incorporate their patients’ perspectives into their counseling. These skills are acquired with increasing clinical experience. The apprenticeship model of medical education in the setting of current duty hour restrictions is increasingly challenging. In this current environment of restricted resident work hours, physician-educators must strive to balance formal didactic and hands-on training. A recent survey of physician-educators in obstetrics and gynecology (OB/ GYN) by Espey et al reported concerns regarding the negative impact of resident work hours on resident education [2]. With the implementation of the 16hour workday restriction for first year residents, senior level general surgery residents (94% of second- through fifth-year residents) expressed that such restrictions would adversely impact the education of their more junior counterparts [3]
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