by Holly Hayes
A Canadian study, “Assessing Residents’ Communication Skills: Disclosure of an Adverse Event to a Standardized Patient” from the March Journal of Obstetrics and Gynecology Canada (JOGC) reported results of a study to assess “residents’ communication skills involving the disclosure of a poor outcome to a standardized patient using a standardized patient encounter, and to compare their performance before and after formal teaching on disclosure”.
The study found:
It is reassuring that four items were performed very well prior to formal teaching on the subject (“professionalism,” “avoiding barriers,” “speaking at a comfortable rate,” and “using appropriate body language”), the implication being that some of these skills are taught or learned in other ways, either through an innate “bedside manner” or through role-modelling or transfer from other communication skills. We can postulate that the items that were most improved after the educational intervention (“allow time to express feelings,” “introduce the topic,” and “introduce oneself ”) are items that can be taught but are not being taught elsewhere, and are behaviours that are not being modeled. However, an alternative interpretation is that the residents did not demonstrate these skills in an examination setting until they learned that these items were important.
The study concluded: “Residents’ performance in disclosure of adverse events improves after formal teaching.”
This conclusion is in keeping with a study by the Lucian Leape Institute at the National Patient Safety Foundation; Unmet Needs: Teaching Physicians to Provide Safe Patient Care, 2010. The white paper concluded that “[U.S.] medical schools are not doing an adequate job of facilitating student understanding of basic knowledge and the development of skills required for the provision of safe patient care.” The report urged medical schools to: “teach patient safety as a basic science and ensure that students develop interpersonal and communication skills through experiences working in teams with nursing, pharmacy, and other professional students.”
For more on this topic read here and here.
Contact us to learn more about our training in healthy conflict engagement where residents and other staff can learn communication skills to discuss adverse events with patients and techniques to improve collaboration in the workplace.
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Holly Hayes is a mediator at Karl Bayer, Dispute Resolution Expert where she focuses on mediation of health care disputes. Holly holds a B.A. from Southern Methodist University and a Masters in Health Administration from Duke University. She can be reached at holly@karlbayer.com.
