Even years after experiencing a physical trauma, individuals describe trauma-specific distress, as trauma triggers present as sensory reminders that initiate physiological reactions at time of exposure. Mobile technologies offer tremendous potential in helping individuals who have experienced trauma manage symptoms as they transition out of hospital care and move back into their communities where they are at risk of trauma trigger exposure. A personalized wearable device, tailored to a patient-specific diagnosis (e.g., PTSD) with programmable neurophysiological behavioral risk set-points, could be a useful tool in helping individuals monitor symptomology. When this type of monitoring device is also connected to a personalized recovery cue intervention on a smartwatch or phone, and activated when the wearable sensor detects heightened risk, there is the opportunity for in-the-moment symptom management. In this study we sought to understand the value for trauma survivors of using this type of personalized mobile recovery support system. Study participants were all trauma survivors or family members of survivors who were involved in the Trauma Survivors Network. A semi-structured interview was conducted with participants to understand perceptions on the utility, sensory experiences, and innovation insights of a mobile recovery sensory support system overall, and about the recovery cue intervention most specifically. Results from participant interviews inform the further development of our mobile recovery support system model in significant ways, suggesting that three components must be included: 1) Recovery cues; 2) Relationships (connecting to supportive network); and 3) Regulation (neurophysiological regulation and behavioral risk reduction).
Background
Communication skills are essential to providing patient-centered care. The need for standardized communication skills training is at the forefront of medical school and residency education. We aimed to design and implement a curriculum teaching virtual communications skills to medical students. The purpose of this report is to describe our experience and to offer guidance for training programs developing similar curricula in the future.
Methods
The curriculum was presented in weekly modules over 5 weeks using Zoom technology. We focused on proven strategies for interacting with patients and other providers, adapted to a virtual platform. Skill levels during role-play were assessed by the Simulated Participants and students observing the simulation using the 14-item, physician specific Communication Assessment Tool (CAT). The primary outcome of the CAT is the percentage of “excellent” for each item ranked both years. Participants provided feedback on what worked well or how the module could be improved in open-ended responses.
Results
Twenty-eight and 25 students registered for the course in Year 1 and Year 2, respectively. Students’ post-session confidence in their ability to perform target skills was statistically higher than their pre-session scores in most sessions. Modules with the lowest pre-session confidence for both years were “Disclosing a Medical Error” and “Responding to Patient Bias.” The mean percentage of students receiving “excellent” scores on individual CAT items ranged from 5 to 73% over the course of both years. Verbal and written feedback in Year 1 provided direction for the curriculum developers to improve the course in Year 2.
Conclusions
Developing and implementing a new education curriculum is a complex process. We describe an intensive curriculum for medical students as we strive to allow students extra “clinical” time during COVID-related restriction. We believe continued focus on patient and family communication skills will enhance patient care.
Supplementary Information
The online version contains supplementary material available at 10.1007/s44186-022-00054-9.
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