Human Emotion and Response in Surgery (HEARS): A Simulation-Based Curriculum for Communication Skills, Systems-Based Practice, and Professionalism in Surgical Residency Training

Larkin, Anne C.; Cahan, Mitchell A.; Whalen, Giles F.; Hatem, David S.; Starr, Susan; Haley, Heather-Lyn; Litwin, Demetrius E. M.; Sullivan, Kate; Quirk, Mark E.

doi:10.1016/j.jamcollsurg.2010.04.004

Cited by 64 publications

(48 citation statements)

References 21 publications

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“…61,[81][82][83][84][85][86][87][88] Similar lists can be derived from consideration of instruments used to assess communication skills. 89 It is possible to create an amalgam of these skills, which can be considered as a best practice for communication in medical encounters (T A B L E 3).…”

Section: Patient Views Of Physician-patient Communicationmentioning

confidence: 99%

“Best Practice” for Patient-Centered Communication: A Narrative Review

King¹,

Hoppe²

2013

Journal of Graduate Medical Education

434

310

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Background Communicating with patients has long been identified as an important physician competency. More recently, there is a growing consensus regarding the components that define physician-patient communication. There continues to be emphasis on both the need to teach and to assess the communication skills of physicians. Objective This narrative review aims to summarize the work that has been conducted in physician-patient communication that supports the efficacy of good communications skills. This work may also help to define the physician-patient communication skills that need to be taught and assessed. Results A review of the literature shows it contains impressive evidence supporting positive associations between physician communication behaviors and positive patient outcomes, such as patient recall, patient understanding, and patient adherence to therapy. There is a consensus about what constitutes “best practice” for physician communication in medical encounters: (1) fostering the relationship, (2) gathering information, (3) providing information, (4) making decisions, (5) responding to emotions, and (6) enabling disease- and treatment-related behavior. Conclusions Evidence supports the importance of communication skills as a dimension of physician competence. Effort to enhance teaching of communication skills to medical trainees likely will require significant changes in instruction at undergraduate and graduate levels, as well as changes in assessing the developing communication skills of physicians. An added critical dimension is faculty understanding of the importance of communication skills, and their commitment to helping trainees develop those skills.

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Section: Patient Views Of Physician-patient Communicationmentioning

confidence: 99%

“Best Practice” for Patient-Centered Communication: A Narrative Review

King¹,

Hoppe²

2013

Journal of Graduate Medical Education

434

310

View full text Add to dashboard Cite

show abstract

“…23 We found only 2 published simulation-based communication curricula in which a needs assessment was initially conducted. 23,24 Neither curriculum, however, posed questions to the learners themselves and instead focused on faculty and nurse perceptions. Our design is unique in that curriculum development relied heavily on the perceived needs of intended learners, a feature suggested by adult learning theorists to promote learner engagement.…”

Section: Discussionmentioning

confidence: 99%

A Simulation-Based Curriculum To Address Relational Crises in Medicine

Peterson¹,

Porter²,

Calhoun³

2012

Journal of Graduate Medical Education

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Introduction Preparing health care professionals for challenging communication tasks such as delivering bad news to patients and families is an area where a need for improved teaching has been identified. Objectives We developed a simulation-based curriculum to enhance the skills of health care professionals, with an emphasis on the communication of difficult or bad news, which we termed relational crises. Methods Our approach was based on a review of existing simulation-based curricula, with the addition of unique features, including a learner-focused needs assessment to shape curriculum development, use of 360-degree evaluations, and provision of written feedback. Development and implementation of our curriculum occurred in 3 phases. Phase I involved a multidisciplinary needs assessment, creation of a clinical scenario based on needs assessment results, and training of standardized patients. In Phase II we implemented the curriculum with 36 pediatric and internal medicine-pediatrics residents, 20 nurses, and 1 chaplain. Phase III consisted of the provision of written feedback for learners, created from the 360-degree evaluations compiled from participants, observers, faculty, and standardized patients. Results Participants felt the scenarios were realistic (average rating of 4.7 on a 5-point Likert scale) and improved their practice and preparedness for these situations (average rating, 4.75/5 and 4.18/5, respectively). Our curriculum produced a statistically significant change in participants' pre- and postcurriculum self-reported perceptions of skill (2.42/5 vs. 3.23/5, respectively, P < .001) and level of preparedness (2.91/5 vs. 3.72/5, respectively, P < .001). Discussion A simulation-based curriculum using standardized patients, learner-identified needs, 360-degree evaluations, and written feedback demonstrated a statistically significant change in participants' self-perceived skills and preparedness for communicating difficult news in pediatrics.

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“…First and foremost, many SBP studies are focused on effective instructional methods or program environments, rather than determining the ability of an individual learner. 33,46,48,52 We need to link assessment to the skills of individual learners when performing or applying the knowledge in clinical practice, which is the highest level of competency in Miller's schema. This perspective supports the use of workplace-based assessments.…”

Section: Portfoliomentioning

confidence: 99%

Assessing Systems‐based Practice

Chen¹,

O’Sullivan

Pfennig

et al. 2012

Academic Emergency Medicine

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The conceptual definition of systems-based practice (SBP) does not easily translate into directly observable actions or behaviors that can be easily assessed. At the Academic Emergency Medicine consensus conference on education research in emergency medicine (EM), a breakout group presented a review of the literature on existing assessment tools for SBP, discussed the recommendations for research tool development during breakout sessions, and developed a research agenda based on this discussion.ACADEMIC EMERGENCY MEDICINE 19:1366-1371 © 2012 by the Society for Academic Emergency Medicine T he inclusion of systems-based practice (SBP) as one of the Accreditation Council for Graduate Medical Education (ACGME) core competencies highlights the importance of the health care system on the ability of a physician to provide competent and effective patient care.1 Physicians must be able to collaborate with other members of the health care team, consider costs when weighing risks and benefits, improve system performance by identifying system errors and implementing potential solutions, and continue to advocate for quality patient care. This set of skills is also described in the CanMEDS Physician Competency Framework as elements of the physician role as a collaborator, manager, and health advocate. Despite a recent shift in the ACGME assessment system to the Next Accreditation System, the framework for assessing milestones within the competencies still requires specific tools to assess SBP.3 Although the conceptual definition of SBP does not easily translate into observable actions or behaviors, the Council of Emergency Medicine Residency Directors (CORD) was able to develop emergency medicine (EM)-specific evaluation domains for SBP. 4 These included specific actions and behaviors that are directly observable and facilitated real-time and summative feedback. However, this set of observable behaviors did overlook some pertinent areas, such as situational awareness and participation in systems improvement. Similarly, by using the Can-MEDS roles of collaborator, manager, and health advocate, Graham et al. also developed a comprehensive list of observable actions that readily translated into assessments. 5This article summarizes the authors' review of the current assessment tools for the SBP competency used in EM and non-EM residencies, both within and outside the United States. As a result of several small group discussions during the breakout session on the assessment of observable learner performance at the 2012 Academic Emergency Medicine (AEM) consensus conference on education research in EM, we developed a research plan for assessment tool development. PROCESS AND CONSENSUSWe reviewed the literature on SBP assessment, searching the Medline and Pubmed databases by combining the terms "systems based" with "evaluat* OR assess*" and "competenc*" as well as combining "simulation" or "portfolio" with "systems based practice," yielding 156 and 309 references, respectively.

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Human Emotion and Response in Surgery (HEARS): A Simulation-Based Curriculum for Communication Skills, Systems-Based Practice, and Professionalism in Surgical Residency Training

Cited by 64 publications

References 21 publications

“Best Practice” for Patient-Centered Communication: A Narrative Review

“Best Practice” for Patient-Centered Communication: A Narrative Review

A Simulation-Based Curriculum To Address Relational Crises in Medicine

Assessing Systems‐based Practice

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