Relationship Express: A Pilot Program to Teach Anesthesiology Residents Communication Skills

Abstract

Background 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. Methods 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. Results 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. Conclusions 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.

Effect of a simulation-based workshop on breaking bad news for anesthesiology residents: an intervention study

“…Death and serious adverse events associated with anesthesia are rare, but when they occur, they usually arise suddenly and unexpectedly. Unlike physicians in some fields of medicine who may get ready in advance for BBN, anesthesiologists cannot avoid such situations, since they have to immediately announce the death or the occurrence of an intra-operative adverse event to the family of an anesthetized patient [ 11 ]. BBN in this context lacks the benefits of an ongoing professional relationship with the patient and is done with the patient’s anxious family.…”

“…Formal teaching does not often address communication skills and residents learn BBN “on the job” [ 11 ]. This training is highly variable and context specific, as many of the “teachers” themselves have had no formal training [ 12 ].…”

Application of Kern’s 6-Step Approach in the Development of a Novel Anesthesiology Curriculum for Perioperative Code Status and Goals of Care Discussions

“…18,33,34 Surgical residents also reported that OSCEs simulating EOL discussions in the intensive care unit are helpful and authentic. 35 Step 2-Targeted Needs Assessment While a limited number of previously published studies have described methods for teaching communication skills to anesthesiology residents, 36,37 no formal training programs specifically aimed at conducting CSD/GOCD have been reported for this group of trainees. Yet the anesthesiology milestones project specifically identifies "negotiates and manages patient and family conflicts in complex situations, including end-of-life issues" as a pertinent competence in the Interpersonal and Communication Skills domain.…”

Development of a Comprehensive Communication Skills Curriculum for Pediatrics Residents

“…The majority of curricula occur singularly 20,21 or at discrete intervals. 22 Full integration with assessment, experiential learning, and multiple communication domains have been cited as markers of a fully mature communication curriculum, 1 yet examples are rare. 23,24 Similar to other programs, our institution offered only a singular, stand-alone course in communication, centered around delivering bad news.…”