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Towards Clear and Caring Communication Always

Home health care worker and elderly woman

Partnering with patients and families to develop and evaluate a simulation-based program for training residents on ‘information sharing’ and ‘caring’ aspects of patient- centered communication

We partnered with patient advocates and an interprofessional team of healthcare providers and personnel to create a brief education program that uses simulation and patient feedback to advance medical residents' patient-centered communications skills. After a series of meetings and seeking broader input from patients, students and other providers, consensus was achieved on the need to focus the program on particularly challenging areas in patient-physician communication.

Those areas pertained to clear information sharing, ensuring patient understanding and handling difficult conversations. The program was pilot tested in 2013 with 16 Internal Medicine residents and nine Physical Medicine and Rehabilitation residents at Johns Hopkins School of Medicine in Baltimore, Maryland. Residents were provided with pre-simulation preparatory materials that included a short slide set with overview on patient-centered communication skills, pointers on how to handle various simulation scenarios and a select reference articles.

This project utilized Standardized Patient (SP) simulations, where SPs are carefully recruited and trained to take on the characteristics of a real patient thereby affording the student an opportunity to learn and to be evaluated on learned skills in a simulated clinical environment. Residents worked with three SPs on three scenarios.

  • Breaking bad news
  • Dealing with an angry patient
  • Discussing therapeutic options

Feedback was provided by the SPs after each of the encounters with a scenario-specific checklist. Simulation encounters were video recorded, and the link was provided to the residents for review after the activity.

The vast majority of the residents reported that the SP feedback was helpful and that the simulation was a positive experience.

Resources

Always Clear and Caring: An education program in patient-centered communication – training materials

Principal Investigator: Hanan Aboumatar, M.D., M.P.H.

Project Team: Bickey Chang, Adrian Alday, Gail Berkenblit, Sanjay Desai, Carol Fleishman,R. Samuel Mayer, Pat Thomas, Zackary Berger, Mark Hughes, Paula Phurrough, Charlene Rothkopf, Peter Pronovost

Funding Agency: Picker-Gold Foundation/ACGME Challenge Grant

Project Dates: April 2012-2013