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Training helps surgical residents improve some communication skills

But progress was not seen in empathy, pacing of dialogue and eliminating jargon when talking to patients, a study shows.

By — Posted Aug. 30, 2011

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With some training, surgical residents can improve the quality of information they communicate to patients about a specific condition, such as prostate cancer. But the training doesn't improve more general communication skills, such as empathy, says a study in the August Archives of Surgery.

The study focused on 44 University of Connecticut School of Medicine general surgery residents who participated in a three-part interactive program. The program featured learning principles of patient communication, role-playing, and hearing a surgeon's experience as a physician, patient and patient's spouse.

Before the training, residents scored a median 65% on a checklist of items they needed to cover with patients, including explaining what type of cancer the patient has, asking about the patient's emotions and discussing treatment. After training, the median score for what the study called case-specific communication skills jumped to 84% (link).

But improvement was not seen in general communication skills such as pacing of dialogue, questioning, effective summarizing and eliminating jargon when talking to a patient. Empathy and other nonverbal communication didn't improve, either.

Study lead author Rajiv Y. Chandawarkar, MD, said it was encouraging to see that a short burst of training could improve case-specific communication.

"Case-specific information is very critical to the actual care of patients. ... You can address questions before a patient has even had a chance to form them," said Dr. Chandawarkar, associate professor and chief of the division of plastic and reconstructive surgery at the University of Connecticut School of Medicine in Farmington.

To enhance general communication skills, such as decreasing jargon and improving effective summarizing, study authors said it probably would take "sustained coaching with repeated practice rather than a one-time session" to see improvement. They noted that empathy and nonverbal communication have an innate component, making it more difficult to improve such skills.

The Accreditation Council for Graduate Medical Education lists communication as a core competency for physicians in training. Dr. Chandawarkar said residency programs need to focus more on helping physicians in training improve patient communication.

"Training now is focused on creating technically good doctors," he said. "But without communication skills, even the best doctors won't achieve their potential."

Study authors said their training methods could be modified for other residency programs and used in teaching hospitals and community health centers. Though the study focused on how to communicate with a cancer patient, Dr. Chandawarkar said the training could help residents communicate about scenarios such as end-of-life care, trauma, pediatric care and care for the elderly.

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