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Effectiveness of a brief training program in relational/communication skills for medical residents
Institution:1. Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal;2. Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy;1. Radboud University Medical Center, Radboud Institute for Health Sciences, Scientific Institute for Quality of Healthcare (IQ healthcare and Institute for Health Service Research), Nijmegen, the Netherlands;2. Radboud university medical cUniversity Medical Center, Radboud Institute for Health Sciences, Department of Primary and Community Care, Nijmegen, the Netherlands;3. NIVEL (Netherlands Institute for Health Services Research), Utrecht, the Netherlands;4. Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway;5. Radboud university medical cUniversity Medical Center, Radboud Institute for Health Sciences, Department of Rheumatology, Nijmegen, the Netherlands;6. HAN University of Applied Sciences, Institute of Nursing, Nijmegen, the Netherlands;1. Durham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Medical Center, Durham, NC, United States;2. Division of General Internal Medicine, and Departments of Population Health Sciences and Psychiatry and Behavioral Sciences, School of Medicine, and School of Nursing, Duke University, Durham, NC, United States;1. Gillings School of Global Public Health, University of North Carolina at Chapel Hill, United States;2. School of Medicine, University of North Carolina at Chapel Hill, United States;3. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, United States;4. Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, United States;5. School of Medicine, University of California, San Francisco, United States;1. Department of Developmental Psychology and Socialization, University of Padova, Padova, Italy;2. Department of Surgical, Oncological and Gastroenterological Sciences, University of Padova, Padova, Italy;3. Department of Humanities, University of Ferrara, Ferrara, Italy;4. Unit of Hereditary Cancer, Ospedale Policlinico San Martino, Genova, Italy;1. University of Massachusetts Medical School, Worcester, Massachusetts;2. Department of Radiology, Staten Island University Hospital Northwell Health, Staten Island, New York;3. Department of Radiology, University of Texas Medical Branch, Galveston, Texas;4. Department of Radiology, Boston Children’s Hospital, Boston, Massachusetts;5. Harvard Medical School and Beth Israel Deaconess Medical Center, Boston, Massachusetts
Abstract:ObjectiveTo assess the effectiveness of a brief training program in relational/communication skills (RCS) for medical residents.MethodsThis longitudinal study enrolled 64 medical residents who participated in a RCS training program in small groups. Teaching was based on interviews with standardized patients and reflective practice. Video-recorded consultations were coded according to the Verona-Coding-Definitions-of-Emotional-Sequences (VR-CoDES) and a coding system developed to assess ten communication skills for breaking bad news. The outcome measures were: independent raters’ score in RCS for breaking bad news and the percentage of providing space and empathic responses, by comparing baseline (T1) skills with those after three-days (T2) and three-months (T3).ResultsAfter the training program residents provided more space for further disclosure of cues and concerns according to VR-CoDES definitions. There were significant improvements in seven of the ten communication skills for breaking bad news. All of these improvements were observed either at T2 or at T3.ConclusionThis study demonstrates the effectiveness of a brief RCS training program designed to improve medical residents’ ability to respond appropriately to patients’ cues and concerns and to conduct a breaking bad news encounter.Practice implicationsBrief RCS training programs adopting multiple approaches, should be offered as mandatory during residency programs.
Keywords:Breaking bad news  Communication skills training  Relationship-centered care  Standardized/simulated patient  Residents  VR-CoDES
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