Objective: The objective of this paper is to report the implementation and assessment of the Comskil Training Curriculum at Memorial Sloan-Kettering Cancer Center.Method: Twenty-eight attending physicians and surgeons participated in communication skills training modules as part of a train-the-trainer program. Doctors were video recorded in clinical consultations with patients two times before training and two times after training, resulting in 112 video recordings for analysis. Recordings were coded using the Comskil Coding System.Results: Communication skills related to two of the six major skill sets, Establishing the Consultation Framework and Checking, increased following training. Limited changes emerged in three skill sets, while one skill set, Shared Decision Making, did not change. Doctors who attended more training modules had higher levels of change. Female participants demonstrated three skills more frequently than males post-training.Conclusions: The intervention produced significant communication skills uptake in a group of experienced attending clinicians, mediated by the amount of training. Future research should focus on the dose of training necessary to achieve skills uptake and the effect of skills training on patient outcomes.

Communication Skills Training (CST) is a proven aid to help oncologists achieve high quality patient-centered communication. No research studies have provided clear guidelines for developing the content of CST. The aim of this work is to describe a method of developing such content and evaluation of effectiveness of CST training workshops (based on this method) in a real world medical education setting at Memorial Sloan-Kettering Cancer Center. Using a set of seven sequenced steps, we have developed a curriculum for training oncology fellows in several communication challenges. Oncology fellows (n045) participated in CST workshops. A coding system was applied to each participant's consultation video-recordings pre and post training. Participants completed evaluations of their confidence and self efficacy in communication skill usage. The training increased the fellows' overall level of skill usage (t 44 0(2.426, p B.05). All participants strongly agreed that they would use newly acquired skills, provide better care after training, and had also been prompted to critically evaluate their own communication skills.Further modules are planned; however, different methods of assessment may be more appropriate in the medical education setting.

Modest training and minimal practice does not result in complete facilitator competence. Some facilitation skills appear to be more easily acquired than others. These findings highlight which skills should be prioritised in the further training of novice facilitators. A long-term project currently underway will study whether facilitator competence improves with practice and regular feedback.

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Community schools link students, families, and communities to educate children and strengthen neighborhoods. They have become a popular model for education in many US cities in part because they build on community assets and address multiple determinants of educational disadvantage. Since community schools seek to have an impact on populations, not just the children enrolled, they provide an opportunity to improve community health. Community schools influence the health and education of neighborhood residents though three pathways: building trust, establishing norms, and linking people to networks and services. Through such services as school-based health centers, nutrition education, family mental health counseling, violence prevention, and sexuality education, these schools build on the multiple reciprocal relationships between health and education. By developing closer ties between community schools and neighborhood health programs, public health professionals can help to mobilize a powerful new resource for reducing the health and educational inequalities that now characterize US cities. We suggest an agenda for research, practice, and policy that can build the evidence needed to guide such a strategy.

In this article, we compared the characteristics of public and private accredited public health training programs. We analyzed the distinct opportunities and challenges that publicly funded schools of public health face in preparing the nation's public health workforce. Using our experience in creating a new, collaborative public school of public health in the nation's largest urban public university system, we described efforts to use our public status and mission to develop new approaches to educating a workforce that meets the health needs of our region and contributes to the goal of reducing health inequalities. Finally, we considered policies that could protect and strengthen the distinct contributions that public schools of public health make to improving population health and reducing health inequalities.

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Bronchiolitis is a seasonal viral lower respiratory tract illness common in infancy and a major cause of hospitalisation in this age group. The course is often self-limiting. Mainstay of management is supportive care to maintain oxygenation and hydration. We developed local guidelines for the management of bronchiolitis based on recommendations from NICE and Bronchiolitis of Infancy Discharge Study (BIDS). Key messages being: minimal handling and suctioning, rare pharmacological treatment in selected cases and permissive approach to patients with saturations>90% (BIDS). This guidance was implemented using a robust teaching program for all staff including nurses and junior doctors. We aimed to audit current management of bronchiolitis and compliance with new guideline. We also compared outcomes with practice before implementation of new guideline.MethodsAn audit proforma was designed and the new trust guideline – 2015/2016 was used as gold standard. Data was collected using clinical coding, case notes, electronic case records. Data on 30 patients admitted with bronchiolitis between October 2014 to December 2014 was collected. The new guideline was implemented in December 2015. We collected data on infants admitted with bronchiolitis between 1st January and 31st March 2016 in RBHSC. A total of 29 patients were included in this cohurt.ResultsSuctioning was reduced from 83% to 34%, so as the use of hypertonic saline nebulisers. There was a slight increase in the use of antibiotics. No change was seen with regards to duration of stay. 1 patient was readmitted in 2016 compared with 5 patients in 2014.ConclusionCompliance to the new guideline was good and minimal handling and suctioning did not prolong the stay or readmission.Abstract G374(P) Table 1Oct – Dec 2014 (n–30)Jan-Mar 2016 (n–29)Suctioning25 (83%)10 (34%)Hypertonic saline nebuliser9 (30%)3 (10%)Salbutamol nebuliser7 (23%)8 (27%)Adrenaline nebuliser5 (17%)2 (7%)Antibiotics3 (9%)7 (24%)