Surgical EducationLearning by (video) example: a randomized study of communication skills training for end-of-life and error disclosure family care conferences
Section snippets
Methods
In the fall of 2014, all categorical PGY1 and PGY3 residents (n = 72) in general and orthopedic surgery programs at the University of Minnesota (UMN) and Mayo Graduate School (Mayo) were enrolled in the study. This included 28 UMN residents (n = 12 general surgery, n = 16 orthopedic) and 44 Mayo residents (n = 20 general surgery, n = 24 orthopedic). All 4 program directors required these residents to take the Family Conference OSCE as part of their annual ACGME Milestone evaluations. They also
Results
Pretest OSCE scores were obtained from 70 of the 72 potential subjects. Paired pre-post OSCE performance scores were obtained for 54 of 70 subjects (see Table 1). Attrition in the sample was due to residents leaving the program (n = 2), excused absences from the post-test (n = 5), and missing data (n = 9). Most of the attrition occurred at 1 site (Mayo), and within 1 specialty (orthopedics), largely due to technical difficulties with B-Line unfortunately occurring on the day many of the
Comments
The ACGME requirement to teach and assess professional interpersonal communication core competencies presents significant challenges to surgery departments, given duty-hour restrictions, compressed curriculum time (accompanied by medical knowledge explosion), and increased clinical demands. At our institutions, there were just no “extra hours” for resident education.
Perhaps sensing these constraints, 1 research team working with practicing oncologists tried an independent learning with feedback
Conclusions
The reality of enhancing professionalism, interpersonal, and communication skills remains daunting for many surgery departments. In this article, we report the results of a labor-intensive study in which a hybrid (online, F2F) intervention was created and rigorously tested with general surgery and orthopedic surgery residents at 4 training programs. Our primary “lesson learned” was that online interventions—even ones that are short and highly visual—are limited if their usage relies primarily
Acknowledgments
The authors are indebted to Ken Yoshida, PhD, for viewing hundreds of hours of videotapes and excerpting examples; and to the UMN AHC Simulation Center staff (Anne Woll, Doug Lakes, Joseph Miller, Alison Von Achen), and the Mayo Simulation Center staff (Denise Foy, Thomas Belda), for implementing the OSCEs. They also thank Maura Sullivan, PhD, for reading a draft of the article. This study was supported in part from a grant from the Association of Surgical Education and the Association of
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2019, Surgical Clinics of North AmericaCitation Excerpt :Similarly, in-person or Web-based workshops, although more effective than standard lecture-based didactics, show no consistent relationship between the length of training and efficacy.54,58,59 To be effective, online curricula must include face-to-face interactions with feedback and discussion.60 Although the best data for improving provider practice, comfort, and confidence in communication are obtained through witnessed interactions with feedback,54 communication tools have been developed to assist with specific interactions or situations.
Training physiotherapy students to educate patients: A randomised controlled trial
2018, Patient Education and CounselingCitation Excerpt :Although no one single approach to training is suitable for all students [42], teaching approaches that incorporate principles of adult learning such as experiential and problem based learning are supported within health educational literature [43,44]. Simulation approaches using patient actors [44–48] and video-based examples [48,49] in particular, have yielded positive results for clinical and communication competencies of health professional students [44–47]. Furthermore, previous research demonstrates that brief, high intensity, active approaches using multiple teaching and learning strategies enhance knowledge, self-efficacy and performance of patient-centred care [44].
There were no relevant financial relationships or any sources of support in the form of grants, equipment, or drugs.
The authors declare no conflicts of interest.