Communication Skills Curriculum Research Articles

The science of talk in clinical science: using a conversation analytic approach as a foundation for communication skills training

This article was migrated. The article was marked as recommended. Communication skills are considered a central part of medical and health professional curricula. The focus for both theoretical knowledge and practical skills in these curricula is often, necessarily, on that which is directly relevant to consultations and other clinical activities. Prior to engaging in this more specific and often experiential learning, it is arguable that the inclusion of foundational learning around how interaction works to adequately scaffold more specific, clinically-contextualised learning, building through the zone of proximal development. In this paper, I describe a conversation analysis-informed curriculum for communication skills in an undergraduate pre-clinical science degree which is designed to enhance the ability to critically and constructively reflect on their own communication.

An Exploration of the Performance and Generalization Outcomes of a Social Skills Intervention for Adults with Autism and Intellectual Disabilities

Deficits in social communication skills present significant challenges for individuals with autism spectrum disorder (ASD), yet few evidence-based social skills interventions exist for adults with ASD and intellectual disabilities. The current study investigated the efficacy of a social skills intervention, which comprised of the Walker Social Skills Curriculum: The ACCESS program (Adolescent Curriculum for Communication and Effective Social Skills), video modeling, and the addition of generalization programming, to target social skills for community inclusion. A multiple-probe single-case experimental design and pre/post outcome measures were used to evaluate the effects of the social skills intervention on improving social communication skills in six adults with ASD and intellectual disabilities. Participants received 20 intervention sessions, each session delivered for 1.5 h, twice per week. Generalization of target skills was programmed through the inclusion of, (a) training in the natural setting, (b) introducing natural maintaining contingencies, (c) multiple exemplar training, and (d) incorporating social situations and common stimuli from the natural setting in the training sessions. All participants demonstrated increases in social communication skills with skills generalizing to natural environments. In addition, significant improvements in overall social skills as measured by the SSiS, SRS-2, and the ACCESS Placement Test were shown following the social skills intervention. The generalization of newly acquired skills varied across participants highlighting that other variables may impact on treatment effects. Therefore, consideration of and support for social skills interventions that program and assess for the generalization of treatment effects are needed. Implications for practice and future research are discussed.

Serious Illness Communication Training for Heart Failure and Cardiology Fellows

Introduction Integration of palliative care (PC) into management of patients with advanced heart disease (AHD) improves quality of life and is endorsed by consensus guidelines. Because of the limited availability of specialty PC providers, equipping cardiologists with communication skills for serious illness conversations is paramount to ensuring access to PC for all patients with AHD. Surveys have shown that fellows in training are frequently involved in late goals of care conversations with AHD patients, yet few receive training in communication skills. CardioTalk is a communication skills workshop created using the VitalTalk ( www.vitaltalk.org ) model, which has been shown to improve communication skills for oncology, nephrology, and geriatrics fellows. Hypothesis Adapting and implementing a serious illness communication skills curriculum for cardiology and heart failure fellows will be feasible, useful, and valued. Methods General cardiology and heart failure fellows participated in a communication skills workshop using a VitalTalk curriculum adapted for AHD. Sessions were taught by VitalTalk-trained educators, and were structured as a short didactic, including skills demonstration, followed by small-group practice with simulated patient actors. We used a structured “talking map” framework for late goals of care conversations, and specifically taught delivering serious news, responding to emotion, eliciting patient preferences and values, and making recommendations. A Likert scale-based questionnaire was used to assess fellows’ perceptions of the educational quality of the workshop, as well as the utility of skills learned. Results Twenty-three fellows participated. Overall educational quality of the workshop was rated highly, with an average score on the Likert scale of 4.8/5 (with 1 - “Poor” and 5 - “Excellent”). Likelihood of using the workshop skills in daily practice was also highly rated, with an average Likert score of 4.8/5 (with 1 - “Not likely at all” and 5 - “Very likely”). Likelihood of recommending this training to a colleague was rated on average 4.8/5 (1 - “Strongly disagree” and 5 - “Strongly Agree”). Qualitative responses suggested fellows took home the importance of responding to emotion rather than cognitive questions, and the utility of using a conversation framework. Fellows requested additional sessions, as well as training in even more complex cases. Conclusions Equipping cardiology and heart failure fellows with serious illness communication skills using the CardioTalk curriculum is feasible, effective and valued. Fellows were eager to learn, and felt their new skills would translate well into clinical practice.

Families as educators: a family-centered approach to teaching communication skills to neonatology fellows.

To determine whether the use of family members as educators in a structured educational intervention would increase neonatology fellows' confidence in performing core communication skills targeted to guide family decision-making. Neonatology fellows at two centers participated in simulation-based training utilizing formally trained family members of former patients. Fellows completed self-assessment surveys before participating, immediately following participation, and 1-month following the training. Family members also evaluated fellow communication. For each core competency assessed, there was a statistically significant increase in self-perceived preparedness from pre-course to post-course assessments. Fellows additionally endorsed using skills learned in the curriculum in daily clinical practice. Family educators rated fellow communication highest in empathetic listening and nonverbal communication. Participation in a communication skills curriculum utilizing formally trained family members as educators for medical trainees successfully increased fellows' self-perceived preparedness in selected core competencies in communication. Family educators provided useful, generalizable feedback.

Look Who's Talking: A Survey of Pediatric Program Directors on Communication Skills Education in Pediatric Residency Programs

ObjectiveTo determine current practices for communication skills curriculum and assessment in pediatric residency programs and to identify programs’ greatest needs regarding communication curricula and assessment. MethodsWe surveyed pediatric residency program directors about their programs’ approach to teaching and assessing residents’ communication skills and how satisfied they were with their curricula and assessment of competence. Respondents were asked about their programs’ greatest needs for teaching and assessing communication skills. ResultsResponse rate was 41% (82/202). Most programs did teach communication skills to residents; only 14% provided no formal training. Programs identified various 1) educational formats for teaching communication skills, 2) curricular content, and 3) assessment methods for determining competence. Many programs were less than satisfied with their curriculum and the accuracy of their assessments. The greatest programmatic need regarding curricula was time, while the greatest need for assessment was a tool. ConclusionsWhile teaching and assessment of communication skills is common in pediatric residency programs, it is inconsistent and variable, and many programs are not satisfied with their current communication training. There is need for development of and access to appropriate and useful curricula as well as a practical tool for assessment which has been evaluated for validity evidence.

De-escalating Angry Caregivers: A Randomized Controlled Trial of a Novel Communication Curriculum for Pediatric Residents

ObjectiveMedical providers struggle when communicating with angry patients and their caregivers. Pediatric residents perceive communication competencies as an important priority for learning, yet they lack confidence and desire more training in communicating with angry families. Few curricula exist to support trainees with de-escalation skill development. We developed, implemented, and evaluated the impact of a novel de-escalation curriculum on pediatric resident communication skills. MethodsWe conducted a randomized controlled trial of a 90-minute de-escalation curriculum for pediatric residents from August to September 2016. Trained standardized patient (SP) actors rated residents’ communication skills following 2 unique encounters before and after the intervention or control sessions. Residents completed a retrospective pre/post communication skills self-assessment and curriculum evaluation. We used independent and paired t-tests to assess for communication improvements. ResultsEighty-four of 88 (95%) eligible residents participated (43 intervention, 41 control). Residents reported frequent encounters with angry caregivers. At baseline, interns had significantly lower mean SP-rated de-escalation skills than other residents (P = .03). Intervention residents did not improve significantly more than controls on their pre/post change in mean SP-rated de-escalation skills; however, intervention residents improved significantly on their pre/post mean self-assessed de-escalation skills (P ≤ .03). ConclusionsDespite significant self-assessed improvements, residents’ SP-rated de-escalation skills did not improve following a skills-based intervention. Nevertheless, our study illustrates the need for de-escalation curricula focused on strategies and peer discussion, suggests optimal timing of delivery during fall of intern year, and offers an assessment tool for exploration in future studies.

Difficult Patient Encounters: Assessing Pediatric Residents' Communication Skills Training Needs.

IntroductionDifficult patient encounters (DPEs) are common and can lead to frustration and dissatisfaction among healthcare providers. Pediatric resident physician experiences with DPEs and curricula for enhancing necessary communication skills have not been well described.Materials and methodsWe used a cross-sectional survey research design for our needs assessment on resident experiences with DPEs. Thirty-three pediatric residents completed this anonymous survey. The survey assessed residents’ experiences with and self-efficacy regarding DPEs. Descriptive statistics were used to analyze the quantitative data. Additionally, two authors independently coded free response data to include in the narrative description of the survey results.ResultsThese survey results include the views of 92% of the residents in the program (33/36). Residents reported a greater frequency of difficult encounters in the inpatient setting than the outpatient setting. The majority of residents rated their communication skills during DPEs as “fair” or “good” (70%, 23/33). Residents tended to have lower confidence when discussing chronic pain, managing parental insistence on a plan, and breaking bad news. They generally reported higher levels of anxiety for scenarios involving angry patients and families, families insisting on a plan, and when breaking bad news. Residents cited many challenges, including working with angry and demanding families. Additionally, residents described difficulty with managing discordant opinions between the family and the healthcare team regarding the care plan. Residents expressed a preference for learning how to manage challenging patient encounters using clinical experiences. Simulation, discussion, and observation of role models also rated highly as educational methods for increasing skills, while most residents rated lectures as the least important means of training skills for these difficult encounters.DiscussionWe found that pediatric residents experience difficult encounters frequently, especially in the inpatient setting. Individual residents vary in their confidence and anxiety levels with different types of difficult encounters and may benefit from not only general communication skills training, but also from targeted training to equip them for the particular contexts they find most challenging. Residents value interactive structured learning activities, including discussion and simulation. Residents most consistently value the opportunity to lead challenging conversations in the clinical setting, especially when followed by effective debriefing and feedback by trained faculty preceptors.ConclusionsNext steps include creating a “Difficult Encounters” communication skills curriculum informed by this needs assessment, which aim to enhance patient care as well as increase resident self-efficacy. In addition to the curriculum development for residents, it may be helpful to initiate faculty development on how to supervise resident-led difficult conversations and provide effective debriefing and feedback to promote resident growth.

Integrating Storytelling into a Communication Skills Teaching Program for Medical Oncology Fellows.

Oncology training focuses primarily on biomedical content rather than psychosocial content, which is not surprising in light of the enormous volume of technical information that oncology fellows assimilate in a short time. Nonetheless, the human connection, and specifically communication skills, remains as important as ever in caring for highly vulnerable patients with cancer. We previously described a year-long communication skills curriculum for oncology fellows that consisted of monthly 1-hour seminars with role play as the predominant teaching method (Epner and Baile, Acad Med. 89:578-84, 2014). Over several years, we adapted the curriculum based on learner feedback and reflection by faculty and teaching assistants and consolidated sessions into quarterly 3-4-hour workshops. We now describe integrating stories into the curriculum as a way of building empathy and warming fellows to the arduous task of dealing with highly emotional content, such as conversations with young patients about transitioning off disease-directed therapy. Learners read and discussed published, medically themed stories; discussed their own patient care stories; and completed brief writing reflections and discussions. They then worked in small groups facilitated by faculty and upper level fellows who functioned as teaching assistants to work on applying specific skills and strategies to scenarios that they chose. Fellows completed anonymous surveys on which they rated the curriculum highly for relevance, value, organization, content, and teaching methods, including storytelling aspects. We conclude that sharing stories can help highly technical learners build reflective ability, mindfulness, and empathy, which are all critical ingredients of the art of medicine.

NephroTalk: Evaluation of a Palliative Care Communication Curriculum for Nephrology Fellows

ContextNephrologists care for a medically complex population that faces difficult decisions around treatment options and end-of-life care. Yet communication training within nephrology fellowship is rare. Prior work suggests that communication training in nephrology can improve perceived preparedness to engage in difficult conversations; however, it is unclear if this training results in improved clinical skills. ObjectivesThe primary aim was to evaluate the efficacy of a three-day curriculum for nephrology fellows (NephroTalk) to improve communication skill acquisition for delivering serious news. We also measured self-reported preparedness for three additional communication tasks taught, including goals of care and transitions at end of life. MethodsThirty-three first- and second-year fellows from seven academic nephrology programs participated in NephroTalk from 2015 to 2016. Pretraining and post-training encounters to deliver bad news with standardized patients were audiorecorded and evaluated using a modified communication checklist. Fellow experience and self-reported improvement in communication tasks were measured using a five-point Likert scale. ResultsSkill use increased after training for seven of the nine skills measured (P < 0.01). The average number of skills gained after training was 3.6 ± 1.8 skills. With increased communication proficiency, post-training encounters were significantly shorter than pretraining encounters (P = 0.03). Fellows reported improved preparedness to engage in all communication tasks taught in NephroTalk curriculum. ConclusionOur findings support NephroTalk as an effective communication skills curriculum for nephrology trainees. Fellows increased their communication skills significantly in delivering bad news leading to more efficient encounters.

Experiential Communications Curriculum to Improve Resident Preparedness When Responding to Discriminatory Comments in the Workplace.

Patients and families can make discriminatory comments leading to physician distress. Residents receive little training in appropriate responses to such comments and may be ill equipped to respond to intolerance without alienating the individual(s) making the comments. We assessed whether a simulated curriculum would enhance pediatrics residents' ability to effectively respond to discriminatory comments. In the 2016-2017 academic year, we modified an existing communication skills curriculum for senior pediatrics residents. Residents engaged a simulated parent who used discriminatory speech in 4 scenarios, followed by a group debriefing. We conducted anonymous surveys to assess residents' preparedness to respond to these comments before and immediately following participation and examined their experience with discriminatory comments in the workplace. The majority of residents reported prior experience with discriminatory comments (32 of 45 [71%] witnessed such comments, and 27 of 48 [56%] were targeted by such comments), most often regarding age, race, and ethnicity. Mean precourse scores ranged from 2.1 to 3.1 (on a 5-point scale) regarding ability to engage in a firm yet respectful dialogue, to reference the hospital code of conduct, to coach a learner to respond, and to facilitate a team debrief. Mean postcourse scores improved significantly for these questions (range 3.8-4.1). The greatest improvement was in referencing the code of conduct (2.1 versus 4.0, P < .001). Immediately after participating in simulation, pediatrics residents reported a significant improvement in self-reported readiness to respond to discriminatory comments made by a parent and reported the simulation experience was beneficial.

Communication skills scores of medical students and interview performance 3 years later

Objective: Communication skills are important, but the evaluation of these skills in the medical curriculum remains inconsistent. The aim of this study was to explore the relationship between the communication skills scores of junior medical students following curricula with different module evaluations and the clinical interview performance of the same students in a psychiatry department in their fifth year. Design: Prospective evaluation of communication and clinical interview skills. Setting: Medical school and psychiatry department inpatient setting. Method: The communication skills scores of 208 medical students in their second year (between 2009 and 2011) and their performance in interviews with patients in a psychiatry department in their fifth year (between 2012 and 2014) were assessed. Initial assessment was undertaken on the basis of problem-based learning (PBL) performance, evaluation of performance during conversation with patients, a related oral presentation and written report, students’ self-rating and a peer rating. Extra marks were given if students completed an optional special report inspired by the curriculum. To assess the interview performance of fifth-year medical students, the mini-Clinical Evaluation Exercise (mini-CEX) was used, together with weekly case-based discussions and the observation of a clinical interview with a real patient. Results: Tutors’ evaluations of the junior medical students’ performance during role-play ( ρ = .22, p = .001), its related reciprocal assessment ( ρ = .18, p = .010) and an extra-effort task ( ρ = .18, p = .009) as part of the communication skills curriculum were significantly correlated with the students’ later performance in a clinical interview with a patient. Conclusion: Observation of student interactions and motivations along with reciprocal peer evaluations offer better measures of communication skills in medical education than are oral presentations, self-ratings and conversations with real patients.

Communication skills curriculum: scripting too soon?

Communication skills curriculum: scripting too soon?

Cost-Effectiveness of Using Standardized Patients to Assess Student-Pharmacist Communication Skills

Objective. To explore the cost-effectiveness of including standardized patients (SP) in the didactic curriculum for application and assessment of students' pharmacist-patient communication skills. Methods. Five role play/case study (RP/CS) activities from a communication skills curriculum were replaced with five SP encounters. Communication was assessed using a rubric. This study developed an economic model to examine the costs and effectiveness of replacing RP/CS events with SP events in knowledge-application and communication assessment. Costs consisted of SP hourly wages for training and delivery of SP events. Outcomes examined were the incremental cost-effectiveness ratio (ICER) per student. Results. The ICER comparing SP to RP/CS was $100.93 higher per student on first-attempt pass rates and $9.04 per one-point increase in the mean score. Conclusion. SP was more effective and more costly than RP/CS. Further research into students' willingness to pay needs to occur before determining if using SPs is cost-effective in teaching communication skills.

Predisposition for Empathy, Intercultural Sensitivity, and Intentions for Using Motivational Interviewing in First Year Pharmacy Students

Objective. To assess first-year pharmacy (P1) students' predispositions (eg, perceptions for empathy, intercultural sensitivity, and motivational interviewing (MI) as a patient-centered communication skillset) and identify potential curricula content/communication skills training needs. Methods. A cross-sectional survey was used to collect students' self-reported perceptions for empathy, intercultural sensitivity, counseling contexts, and projected future MI use. Relationships between variables were explored and logistic regression was used to evaluate intention for using MI in future patient encounters. Results. There were 134 students who participated. Higher predisposition for empathy and for intercultural sensitivity were significantly correlated. Significant predictors for applying MI in future patient encounters were sex, confidence with counseling skills, and current use of MI. Conclusion. Results suggest the need to incorporate innovative training strategies in communication skills curricula. Potential areas include empathy, intercultural sensitivity and significant predictor variables for future MI use. Further investigation in other schools is needed.

Undergraduate medical students’ attitudes towards patient-centredness: a longitudinal study

This article was migrated. The article was not marked as recommended. ObjectiveDue to various reasons patient-centredness has become an attribute most medical institutions aim to develop in their graduates. Research however indicates that there is a decline in undergraduate medical students' attitudes towards patient-centredness as they progress through their training. Most of the studies available are cross sectional studies, therefore a longitudinal study to look at how the attitudes of a specific group of undergraduate medical students change over time can be very useful.Methods A longitudinal study involving undergraduate medical students was employed. These students completed the Patient Practitioner Orientation Scale (PPOS) over the last four years of their training and the mean scores of the PPOS was compared. The PPOS measures two constructs related to patient-centrendness namely "caring" and "sharing".Results and discussionPPOS results indicated that students already exhibited fairly low attitudes towards patient-centredness at the beginning of their clinical rotations in their third year, with no significant decline over the next three years. Reasons why the PPOS scores in this study are generally lower than in other similar populations is not clear, but possibilities that are mentioned are that it might be low from the first year already as well as the lack of a comprehensive communication skills training curriculum.ConclusionOur study showed that students' relatively low attitudes towards patient-centredness did not change significantly during their last four years of training. Implications for this finding is that selection criteria of students could perhaps be reconsidered and deliberate teaching and learning interventions to promote positive attitudes towards patient-centredness should be included as part of a comprehensive communication skills curriculum until students graduate.

Enseñar y aprender habilidades de comunicación clínica en la Facultad de Medicina. La experiencia de la Francisco de Vitoria (Madrid)

Clinical communication has been accepted as an important content of medical curricula and recognized as an essential competence by accreditation bodies and international medical education organizations. “Clinical Communication” skills training requires the student to practice with “standardized patients” under direct supervision and observation and receive specific and personalized feedback. This task requires a small group teaching, through an experiential learning, given by medical teachers specialized in this subject, in an integrated way with other clinical skills, that is, not through aisolate interventions, but throughout the curriculum. We describes the general, managerial, educational features and main educational results of an integrated “Clinical Communication Skills Curriculum” for medical students, implemented at the Universidad Francisco de Vitoria school of medicine during the last six years. Some useful and practical messages for improving teaching and learning these skills in universitary medical education in Spain are extracted.

Lost in translation: Cultural divides in communication skills teaching identified in the ICCH 2016 student symposium

ObjectiveTo provide a platform for learners’ voices at an international conference on communication in healthcare. MethodsA group of medical students were invited to explore their experiences with communication skills learning at a symposium at the 2016 International Conference on Communication in Healthcare in Heidelberg, DE. ResultsStudents from the US, Denmark, Germany, and Russia discussed their experiences with communication skills curriculum at their institutions. We identified divides that have challenged our ability to develop and maintain strong communication skills: 1) valuation of communication skills vs. other topics, 2) curricular theory vs. practice, 3) evaluation vs. feedback, 4) preclinical vs. clinical learning, and 5) the medical student vs. practicing clinician role. ConclusionThe points of transition we identified on the road of communication skills teaching highlight opportunities to strengthen the educational experience for students. Without an effort to address these divides, however, our communication skills may be lost in translation. Practice implicationsStudents value communication skills teaching during their medical education and there are opportunities to translate this to countries that currently lack robust curricula and to the real-life post-graduate setting. Support is necessary from students, teachers, and administrators, and focus on translation of skills during role transitions is needed.

ATTITUDES OF DENTAL INTERNS TOWARDS LEARNING COMMUNICATION SKILLS IN ALEXANDRIA UNIVERSITY

INTRODUCTION: Effective communication not only improves dentist-patient relationships, but also enhances the patient’s satisfaction towards the profession. Dental students are generally receptive to learning communication skills during their academic education and their appreciation for the value of these skills can be significantly improved with training. OBJECTIVES:The objective of this study was to compare the attitudes of dental interns towards learning communication skills at both Faculty of Dentistry Alexandria University (public) and Pharos University (private). MATERIALS AND METHODS: A cross-sectional study using a s questionnaire was carried out among dental interns graduated from the Faculty of Dentistry of Alexandria University (AU) and Pharos University (PU), in 2014. A self-administered, twenty-four-items, Dental Communication Skills Attitude Scale (DCSAS) that contained both positive (PAS) and negative (NAS) attitude subscales was distributed. Participants’ demographic and education related variables were also recorded. Association of the positive and negative attitudes with these variables was determined using appropriate statistical tests as Pearson’s chi square test, Monte Carlo Exact test, Fisher’s Exact and one way ANOVA. RESULTS: A total of 240 dental interns from Alexandria University and 162 dental interns from Pharos University participated in the study, with a response rate of 70.59% and 82.65%, respectively. The mean PAS scores and NAS scores in both universities were almost the same, 52/65 and 31/55, respectively with no significant difference between them. These attitudes were significantly associated with certain background and education-related attributes as gender, age, parents education and previous communication skills training. CONCLUSIONS: Despite the differences in communication skills curriculum, dental interns of both AU and PU had an overall positive and neutral attitude towards communication skills learning with no statistical significant difference between them

Teaching and assessment of clinical communication skills: Lessons learned from a SWOT analysis of Portuguese Angolan and Mozambican Medical Education

BackgroundThe importance of clinical communication skills (CCS) teaching and assessment is increasingly recognized in medical education. There is a lack of outcome-based research about CCS teaching and assessment processes in Portuguese medical education. Our goal is to conduct a SWOT analysis of this process in Portugal, Angola and Mozambique in order to contribute to the establishment of an action plan for more effective CCS teaching and assessment in medical curricula. MethodsBetween 2010 and 2012, semi-structured interviews focused on the state of the art of teaching and assessment of clinical communication skills were conducted with key stakeholders of medical courses in Portugal, Angola and Mozambique. The design corresponds to an exploratory, descriptive and cross-sectional study, with the analysis of the recorded interviews. Interview transcripts were analyzed to identify salient themes/coding template in their discussions of the CCS teaching process. The coding and analysis of the surveys is qualitative. Results87 interviews were performed at the 8 Portuguese, 1 Angolan and 1 Mozambican medical schools. Results indicate that the teaching and assessment process of CCS is in the beginning stages with these commonalities noted: (i) Variability amongst faculty in the teaching and assessment methods, (ii) disconnection of CCS between basic and clinical cycles, (iii) content and process skills and (iv) faculty development. ConclusionsCCS training lacks a formal structure with considerable variation of the CCS teaching process in these countries. The interviews promoted a rise in awareness of this situation and how these skills can enhance the quality of curricular change. Some important opportunities for the development and implementation of a framework of an integrated communication skills curriculum such as curricular reforms and well-established cooperation and networks were identified. The acknowledgement of the importance of integrating these skills in ME by key stake-holders and students in institutions and the identification of champions motivated to commit to the effort are strengths that should be considered to integrate and enhance CCS in the medical curricula.

Development of a Comprehensive Communication Skills Curriculum for Pediatrics Residents.

Effective communication is an essential element of medical care and a priority of medical education. Specific interventions to teach communication skills are at the discretion of individual residency programs. We developed the Resident Communication Skills Curriculum (RCSC), a formal curriculum designed to teach trainees the communication skills essential for high-quality practice. A multidisciplinary working group contributed to the development of the RCSC, guided by an institutional needs assessment, literature review, and the Accreditation Council for Graduate Medical Education core competencies. The result was a cohesive curriculum that incorporates didactic, role play, and real-life experiences over the course of the entire training period. Methods to assess curricular outcomes included self-reporting, surveys, and periodic faculty evaluations of the residents. Curricular components have been highly rated by residents (3.95-3.97 based on a 4-point Likert scale), and residents' self-reported communication skills demonstrated an improvement over the course of residency in the domains of requesting a consultation, providing effective handoffs, handling conflict, and having difficult conversations (intern median 3.0, graduate median 4.0 based on a 5-point Likert scale, P ≤ .002). Faculty evaluations of residents have also demonstrated improvement over time (intern median 3.0, graduate median 4.5 based on a 5-point Likert scale, P < .001). A comprehensive, integrated communication skills curriculum for pediatrics residents was implemented, with a multistep evaluative process showing improvement in skills over the course of the residency program. Positive resident evaluations and informal comments from faculty support its general acceptance. The use of existing resources makes this curriculum feasible.