Resident Communication Skills Research Articles

Resident Involvement in the Post-Operative Conversation: An Underutilized Opportunity to Develop Resident Communication Skills

In today’s practice environment, the attending surgeon develops rapport with patients and their families during the pre-operative visit and provides continuity during the surgical process. Because of this established attending-patient/family relationship and time constraints, residents are often excluded from the immediate post-operative conversation that occurs with the family. Interpersonal and communication skills are a core competency, and the post-operative conversation is an opportunity to further develop these skills.

A 360-degree evaluation of the communication and interpersonal skills of medicine resident physicians in Pakistan.

To provide high-quality patient care, effective communication and interpersonal skills are necessary for physicians. A 360-degree evaluation of residents in the department of medicine was conducted to assess their interpersonal and communication skills. The measurement properties and utility of the multi-source ratings were investigated. A cross-sectional assessment of a cohort of Internal Medicine residents was conducted at the Aga Khan Medical University in Pakistan. Every resident (n = 49) was evaluated by eight raters, including physicians, nurses and unit staff. Each resident also completed a self-evaluation. Evidence to support the validity of the ratings was gathered by exploring performance differences amongst more- and less-experienced providers. Analysis of variance (ANOVA) was employed to test for differences in mean scores, both for rater type and experience (residency year). Generalizability theory was employed to estimate the reliability of the ratings. We received 367/441 (83.2%) completed forms. There was a significant effect attributable to rater source (F = 5.2, P < 0.01). There were no significant differences in mean scores for residents at different levels of training. The mean resident self-assessment scores were significantly lower than those provided by faculty (P < 0.01). Based on eight raters, the reliability of the ratings was moderate (ρ2 = 0.39). The 360-degree evaluation technique can be used to measure the communication and interpersonal skills of residents. It can also provide important data to guide resident feedback. Health care providers and staff who interact with residents on regular basis can, as a group provide moderately consistent judgments of their abilities.

Residents’ Communication Skills Evaluation by OSCE: What Changes Should be done in Educational System?

Background: The doubt in re-allocating some of current resources from holding communication skills workshops to others, we conducted this study to answer: What and how were the communication skills of residents in medical faculty? Were any changes needed to be done in educational system? Objectives: The aim of this study was to find out that, what and how were the communication skills of residents in medical faculty? Were any changes needed to be done in educational system? Materials and Methods: We designed one OSCE station with a standard patient to evaluate 53 Internal medicine residents' communication skills in 2010. We had videotaping with an undercover cam inside a monken to record the residents' interview with SP, by written permission of exam directors. We carefully and repeatedly reviewed the videotapes, analyzed the researcher made validated questionnaires' data using SPSS.16.We also gave detailed feed back to the residents. Results: The mean of Residents’ total score with a normal distribution was 23.62 ± 2.46. Independent- samples T-test [sig. (2-tailed: 0.441)] and Test statistics of Kruskal Wallis test (sig: 0.314) indicated none- significant difference in residents’ total score in different gender and ages. Post Hoc comparisons by using the method of Tukey HSD in One- Way ANOVA indicated that educational impacts of communication skills workshops are not lasting for up to one year. Conclusions: This study makes suggestions to address and overcome the still existing problem of residents’ poor communication skills.

A Brief Educational Intervention To Teach Residents Shared Decision Making in the Intensive Care Unit

Effective communication is essential for shared decision making with families of critically ill patients in the intensive care unit (ICU), yet there is limited evidence on effective strategies to teach these skills. The study's objective was to pilot test an educational intervention to teach internal medicine interns skills in discussing goals of care and treatment decisions with families of critically ill patients using the shared decision making framework. The intervention consisted of a PowerPoint online module followed by a four-hour workshop implemented at a retreat for medicine interns training at an urban, academic medical center. Participants (N=33) completed post-intervention questionnaires that included self-assessed skills learned, an open-ended question on the most important learning points from the workshop, and retrospective pre- and post-workshop comfort level with ICU communication skills. Participants rated their satisfaction with the workshop. Twenty-nine interns (88%) completed the questionnaires. Important self-assessed communication skills learned reflect key components of shared decision making, which include assessing the family's understanding of the patient's condition (endorsed by 100%) and obtaining an understanding of the patient/family's perspectives, values, and goals (100%). Interns reported significant improvement in their comfort level with ICU communication skills (pre 3.26, post 3.73 on a five-point scale, p=0.004). Overall satisfaction with the intervention was high (mean 4.45 on a five-point scale). The findings suggest that a brief intervention designed to teach residents communication skills in conducting goals of care and treatment discussions in the ICU is feasible and can improve their comfort level with these conversations.

425 HOW THE QUALITY OF UROLOGIC RESIDENT CARE AFFECTS PATIENTS' OVERALL HOSPITAL STAY SATISFACTION

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Practice Patterns, Cost effectiveness (III)1 Apr 2013425 HOW THE QUALITY OF UROLOGIC RESIDENT CARE AFFECTS PATIENTS' OVERALL HOSPITAL STAY SATISFACTION David Tzou, Susan Bohnenkamp, and Mike Nguyen David TzouDavid Tzou Tucson, AZ More articles by this author , Susan BohnenkampSusan Bohnenkamp Tucson, AZ More articles by this author , and Mike NguyenMike Nguyen Tucson, AZ More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.1815AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES As one of the ACGME's 6-core competencies, interpersonal and communication skills are an important component of the quality of care provided by resident physicians. We examine factors that influence patient satisfaction with the quality care they receive from residents and determine the association between satisfaction with urologic resident care and overall hospital stay satisfaction. METHODS 605 surveys were collected over 20 months from hospitalized urology patients. Surveys included information on patient demographics, patient satisfaction with care provided by residents, overall hospital stay satisfaction, and patient comments on what was done well or not done well in regards to resident care. Fisher's exact tests were performed to evaluate the association between patient characteristics and resident care or visit satisfaction. Linear regression was performed to determine the association between satisfaction with the quality of resident care and overall hospital stay satisfaction. Analyses were performed using Stata 10.1. RESULTS There was a significant association between patients' satisfaction with resident care and their overall visit satisfaction (p <0.001) with an adjusted R-squared value of 0.62, suggesting that resident care satisfaction accounted for 62% of the variability in overall visit satisfaction. Patient sex was significantly associated with resident care satisfaction, with women less likely to rate residents as “excellent” (p <0.05). There were no significant differences in resident care satisfaction or overall hospital stay satisfaction between patient age and ethnicity. Patient satisfaction with resident care varied between the different residents. The most common positive comments regarding resident care were 1) “the resident answered all questions with clear explanations” and 2) “was attentive, patient and listened”. The most common negative comments regarding resident care were 1) “the resident did not clearly explain the situation” and 2) “the discharge process took too long”. CONCLUSIONS Patients' satisfaction with their overall hospital stay was significantly associated with the quality of the care provided by urology residents. Providing clear explanations was the most commonly reported behavior associated with “excellent” resident care. Not clearly explaining the situation was the most commonly reported behavior associated with “poor” resident care. Improving resident communication skills may therefore improve patients' overall satisfaction with their hospital stay. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e173 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information David Tzou Tucson, AZ More articles by this author Susan Bohnenkamp Tucson, AZ More articles by this author Mike Nguyen Tucson, AZ More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Teaching Residents to “Teach-Back”: Does a Structured Curriculum Including Simulation Improve Pediatric Resident Communication Skills?

Health literacy awareness and improved communication have been identified as key factors that may reduce hospital re-admission rates, and increase both patient satisfaction and patient outcomes.1–3 Recent studies have confirmed that lack of attention to context of care can lead to medical errors.4 The ACGME requires programs to teach and assess these skills in our residents. This study is a pre-post design to assess the efficacy of a multi-modal educational intervention to improve the communication skills of pediatric residents specifically in the areas of context of care and performing “teach-back” in their encounters.

Communication skills training for emergency medicine residents

To determine the effects of a communication skills training program on emergency medicine residents and patient satisfaction. Twenty emergency medicine residents attended a 6-week psychoeducation program that was intended to improve their communication skills. The first three sessions of the psychoeducation program consisted of theoretical education on empathy and communication. Other sessions covered awareness, active communication, and empathic skills on a cognitive behavioral basis using discussion, role play, and homework within an interactive group. The effects of the program were assessed using a communication skills scale, empathy scale, and patient satisfaction survey and were reflected by the reduction in the number of undesirable events between doctors and patients in the emergency department. The mean communication skills score increased from 178.7±19 to 189.2±16 after training (P<0.02). Empathy score also increased from 29.5±9 to 30.7±8, but this difference was not statistically significant (P=0.1). The patient satisfaction survey of 576 patients demonstrated increased scores on confidence in the doctor (88.2±14.6-93.6±10.3; P<0.01); the doctor's respect, kindness, and thoughtfulness (90.3±10.8-94.1±16.5; P<0.01); individualized attention (86.7±9.4-93.9±11.1; P<0.01); devotion of adequate time to listening (88.6±12.3-90.8±14.1; P=0.04); and counseling and information delivery (90.1±11.3-92.2±11.7; P=0.02). The number of undesirable events between doctors and patients decreased 75% from 12 to three. Participation in a communication skills training program was associated with improved communication skills of emergency medicine residents, increased patient satisfaction, and decreased complaints.

Delivering Bad News: Improving Communication Skills Training of Medical Students and Residents Through the Use of Second Life Technology (755)

1.Assessing methods to improve student and resident communication skills with a head-to-head comparison of Second Life technology to more traditional methods.2.Evaluate the effect of training method choice on how residents and students perceive the learning experience.3.Evaluate the validity of using Second Life technology as a teaching tool. One of the most challenging and stressful tasks that clinicians must perform regularly is the communication of bad news with distressed patients. In spite of the importance of this clinical skill, very few doctors receive formal training in this area. Physicians and residents generally report both a lack of confidence and feelings of incompetence when asked to self-assess their communication skills. Research has shown that effective communication is a skill that can be learned. Recently, there have been studies done to explore various methods of communication skills training for adult-learners in medical school and residency programs. Second Life technology is a virtual computer world that has shown promise for providing a positive training experience by allowing trainees to act out a bad news communication experience through the use of “avatars” which are on-line graphical self-representations. 1) Evaluate the effect of various training methods, including the use of Second Life technology, on objective measurements of communication skills 2) Determine how receptive medical trainees are to Second Life technology as a teaching method 3) Examine the validity of using Second Life technology as a teaching tool 4) demonstrate that Second Life technology can improve students' self-assessments of their communication skills. Participating medical students and medical residents were first observed acting as the physician in a clinical scenario during which he/she communicated bad news to a simulated patient. This even was followed by one of 3 pathways to which each was randomized: 1) no additional training, 2) participation in a Second Life scenario using avatars, 3) attending a didactic session. All participants ended the study by participating in an observed scenario similar to the first. Communication skills improved with use of avatars. Second Life is a useful teaching tool.

Multi-source evaluation of interpersonal and communication skills of family medicine residents

There is a lack of information on the use of multi-source evaluation to assess trainees' interpersonal and communication skills in Oriental settings. This study is conducted to assess the reliability and applicability of assessing the interpersonal and communication skills of family medicine residents by patients, peer residents, nurses, and teaching staffs and to compare the ratings with the objective structured clinical examination (OSCE). Our results revealed instruments used by staffs, peers, nurses, and self-evaluation have good internal consistency reliability (α > 0.90), except for the behavioral checklist (α = 0.57). Staffs', peers', and nurses' evaluations were highly correlated with one another (r = 0.722 for staff- and peer-rating, r = 0.734 for staff- and nurse-rating, r = 0.634 for peer- and nurse-rating). However, residents' self-rating and patients-rating were not correlated to ratings by any other raters. OSCE evaluation was correlated to peer-rating (r = 0.533) and staff-rating (r = 0.642), but not correlated to self- or patient-rating. The generalizability study revealed the major sources of variance came from the types of rater and the interaction of residents and types of rater. This study found self-rating and patient-rating were not consistent with other sources of rating on residents' interpersonal and communication skills. Whether variations among different types of rater in a multi-source evaluation should be regarded as measurement errors or complementary information is worth further study.

Resident Scores on a Patient Satisfaction Survey: Evidence for Maintenance of Communication Skills Throughout Residency

To examine whether resident communication skills evaluated through patient satisfaction surveys demonstrate evidence of decline through the 3years of internal medicine residency. Data for this study were collected retrospectively from a database of patient satisfaction surveys completed for internal medicine residents at different levels of training. Patient satisfaction was measured with the Aggregated EVGFP (excellent, very good, good, fair, or poor) questionnaire recommended by the American Board of Internal Medicine. Over a span of 5years (2005-2009), a total of 768 patient rating forms were completed for 67 residents during their 3years of residency training. In postgraduate year (PGY)-1, the residents had a mean satisfaction rating of 4.33 ± 0.48 compared to a mean rating of 4.37 ± 0.45 in their PGY-3year. Analysis of variance indicated no significant difference by PGY level. Our findings demonstrate that resident communication skills and patient satisfaction do not decline during the 3 years of residency. This is contrary to our hypothesis that patient satisfaction would worsen as residents progressed through training.

Communication Skills among Surgical Trainees: Perceptions of Residents in a Teaching Hospital in Northern Nigeria

Objective Communication between the surgeon and the patient is a core clinical skill. The ability to communicate with patients and their family members is very important in the optimum care of the surgical patient. Few studies have assessed communication between surgical trainees and their patients in sub-Saharan Africa. In response to this, the communication skills of residents in the department of surgery were evaluated to determine their perception of competency and perceived need for training in communication skills as a basis for developing an effective education programme. Method A survey of patient care - related communication skills among surgery residents and assessment of competence, rating the importance and perceived need for training in communication skills. Results Most residents rated their skills as either fairly or extremely competent in all areas except in providing bereavement counseling. They found all skills important and indicated a need for training in them. Senior registrars rated their competence and the importance higher in skills relating to breaking bad news, educating and preparing patients and families for surgery and encouraging them to express their anxieties. (p 0.05). Conclusion Residents face difficult communication challenges with patients and their families. There is a dire need for improved education in communication skills. Understanding the surgical trainees perceptions of patient care related communication skills is the first step in designing an effective education programme. Key Words: Communication skills, surgical trainees, perception

Changes in communication skills of clinical residents through psychiatric training

The objective of this study was to clarify whether the communication skills (CS) of clinical residents change before and after psychiatric training and, if so, what factors are related to the change. The 44 clinical residents who agreed to participate in this study were provided with an originally developed self-accomplished questionnaire survey on CS (communication skills questionnaire [CSQ]) and a generally used questionnaire on self-esteem, anxiety, and depressive mood considered to be related to CS at the start and end of a 2-month psychiatric training session. Statistical analysis was conducted for the 34 residents who completed both questionnaires. The CSQ score (t[32]: -2.17, P < 0.05) and assertive CS score, a subfactor of the CSQ (t[32]: -2.74, P < 0.01), were improved after the training. The cooperative CS score also tended to increase after the training. The amounts of change in total CS score and cooperative CS score, which increased after the training, correlated positively with self-esteem and negatively with anxiety and depressive tendency. The amount of change in assertive CS score showed a weakly positive correlation with self-esteem. The results suggested that CS, including assertive CS and cooperative CS, were improved by the psychiatric training. Increasing self-esteem and reducing the tendency toward depression and anxiety are considered to be useful for further improving CS.

Effectiveness of Communication Skills Training on Perceptions and Practice of Pediatric Residents

To assess the effectiveness of a structured communication skills training workshop on the perceptions and practice of pediatric residents. The perceptions and practice of pediatric residents with regard to doctor- patient (parent) communication were evaluated before and 6 weeks after a communication skills training workshop, using a structured questionnaire. Twenty pediatric residents participated in the study. They included nine residents who had completed 1 year of pediatric training and 11 residents who had completed 2 years or more of pediatric training. 9 were female residents and 11 were males. Before the intervention, majority of the residents rated themselves poorly on assessment of their perceptions and practice of communication skills. After the workshop there was overall improvement in the communication skills of the residents. Communication skills of pediatric residents are generally inadequate. Structured training programs will help to improve their communication skills. There is a need to incorporate communication skills training in the pediatric postgraduate curriculum.

29. Pediatric Resident Communication Skills with Adolescent Patients and Relationship to Self-Efficacy

29. Pediatric Resident Communication Skills with Adolescent Patients and Relationship to Self-Efficacy

Relationship express: a pilot program to teach anesthesiology residents communication skills.

The Accreditation Council for Graduate Medical Education requires residency programs to teach 6 core competencies and to provide evidence of effective standardized training through objective measures. George Washington University's Department of Anesthesiology and Critical Care Medicine implemented a pilot program to address the interpersonal and communication skill competency. In this program, we aimed to pilot the Relationship Express model, a series of exercises in experiential learning to teach anesthesiology residents to build effective relationships with patients in time-limited circumstances. The purpose of this paper is to describe the application of this model for anesthesiology training. A total of 7 first-year clinical anesthesiology residents participated in this pilot study, and 4 residents completed the entire program for analysis purposes. Relationship Express was presented in three 1.5-hour sessions: (1) introduction followed by 2-case, standardized patient pretest with feedback to residents from faculty observers; (2) interpersonal and communication skills didactic workshop with video behavior modeling; and (3) review discussion followed by 2-case, standardized patient posttest and evaluation. MODIFIED BROOKFIELD COMMENTS REVEALED THE FOLLOWING THEMES: (1) time constraints were realistic compared with clinical practice; (2) admitting errors with patients was difficult; (3) patients were more aware of body language than anticipated; (4) residents liked the group discussions and the video interview; (5) standardized patients were convincing; and (6) residents found the feedback from faculty and standardized patients helpful. Resident retrospective self-assessment and learning comments confirm the potential value of the Relationship Express model. This program will require further assessment and refinement with a larger number of residents.

Disclosing Medical Errors to Patients

Abstract This is a standardized patient case that has been used to assess the communication skills of radiology residents when disclosing a medical error to a patient. In the case, a 50-year-old wo...

Dealing With an Angry Patient

Abstract This is a standardized patient case that has been used to assess the communication and interpersonal skills of radiology residents when dealing with an angry patient. In the case, the lear...

Evaluating Professionalism and Interpersonal and Communication Skills: Implementing a 360-Degree Evaluation Instrument in an Anesthesiology Residency Program

To implement a 360-degree resident evaluation instrument on the postanesthesia care unit (PACU) rotation and to determine the reliability, feasibility, and validity of this tool for assessing residents' professionalism and interpersonal and communication skills. Thirteen areas of evaluation were selected to assess the professionalism and interpersonal and communication skills of residents during their PACU rotation. Each area was measured on a 9-point Likert scale (1, unsatisfactory performance, to 9, outstanding performance). Rating forms were distributed to raters after the completion of the PACU rotation. Raters included PACU nurses, secretarial staff, nurse aides, and medical technicians. Residents were aware of the 360-degree assessment and participated voluntarily. The multiple raters' evaluations were then compared with those of the traditional faculty. Intraclass correlation coefficients were calculated to measure the reliability of ratings within each category of raters by the Pearson correlation coefficient. Four hundred twenty-nine rating forms were returned during the study period. Fifteen residents were evaluated. The response rate was 88%. Residents were ranked highest on availability and lowest on management skill. The average rating across all areas was high (8.23). The average mean rating across all items from PACU nurses was higher (8.34) than from secretarial staff (7.99, P > .08). The highest ranked resident ranked high with all raters and the lowest ranked was low with most raters. The intraclass coefficients of correlations were 0.8719, 0.7860, 0.8268, and 0.8575. This type of resident assessment tool may be useful for PACU rotations. It appears to correlate with traditional faculty ratings, is feasible to use, and provides formative feedback to residents regarding their professionalism and interpersonal and communication skills.

Development of a Communication Curriculum for Emergency Medicine Residents

Background: The Accreditation Council for Graduate Medical Education requires residency training programs to develop methods to teach and assess communication skills in residents to ensure competence as a practitioner. In response, we piloted a communication curriculum for emergency medicine residents. We describe the curriculum and suggest future directions for development based on the strengths and weaknesses of residents' performance and their reactions to the curriculum. Description: Twenty-six residents in a 3-year program at a university-affiliated county hospital participated. Curriculum components were an introductory session, a single standardized patient encounter using a locally written, unvalidated checklist assessing residents' communication skills, a videotape-facilitated self-assessment, and a private feedback session. Evaluation: Residents demonstrated greatest strengths in basic interpersonal skills and efficient information gathering and greatest weakness in empathy. Residents rated the curriculum favorably. Conclusion: The curriculum as implemented offers an initial foundation for teaching and learning critical care communication. Instruction in empathy requires improvement.

Use of High Fidelity Operating Room Simulation to Assess and Teach Communication, Teamwork and Laparoscopic Skills: Initial Experience

Structured opportunities for learning communication, teamwork and laparoscopic principles are limited for urology residents. We evaluated and taught teamwork, communication and laparoscopic skills to urology residents in a simulated operating room. Scenarios related to laparoscopy (insufflator failure, carbon dioxide embolism) were developed using mannequins, urology residents and nurses. These scenarios were developed based on Accreditation Council for Graduate Medical Education core competencies and performed in a simulation center. Between the pretest scenario (insufflation failure) and the posttest scenario (carbon dioxide embolism) instruction was given on teamwork, communication and laparoscopic skills. A total of 19 urology residents participated in the training that involved participation in at least 2 scenarios. Performance was evaluated using validated teamwork instruments, questionnaires and videotape analysis. Significant improvement was noted on validated teamwork instruments between scenarios based on resident (pretest 24, posttest 27, p = 0.01) and expert (pretest 16, posttest 25, p = 0.008) evaluation. Increased teamwork and team performance were also noted between scenarios on videotape analysis with significant improvement for adherence to best practice (p = 0.01) and maintenance of positive rapport among team members (p = 0.02). Significant improvement in the setup of the laparoscopic procedure was observed (p = 0.01). Favorable face and content validity was noted for both scenarios. Teamwork, intraoperative communication and laparoscopic skills of urology residents improved during the high fidelity simulation course. Face and content validity of the individual sessions was favorable. In this study high fidelity simulation was effective for assessing and teaching Accreditation Council for Graduate Medical Education core competencies related to intraoperative communication, teamwork and laparoscopic skills.