Effectiveness of Pathology Resident Communication Simulation Based Education on Clincial Practice
Sheila Mehri, Andrew Wingerson, Jennie Struijk, Dan Luff, Stephen Raab, Suzanne Dintzis. University of Washington Medical Center, Seattle, WA
Background: In the frozen section room, effective delivery of a diagnosis has immediate impact on patient care. In attempt to train residents in communication skills, we developed communication training modules using simulated clinician-pathologists interactions and checklists with 14 communication elements for performance evaluation. The modules are based on TeamSTEPPS, a nationally implemented evidence-based strategy used for improving communication and teamwork skills among health care professionals. In order to evaluate the current intraoperative consultation practice at our institution and establish a baseline for our training studies, intraoperative communications were audio recorded to determine if basic communication elements on our evaluation checklist were being performed.
Design: Thirty-six intraoperative consultations were recorded throughout a 2 month period and retrospectively reviewed. The conversations involved 15 pathology attendings and 21 pathology residents. Of the 21 resident conversations recorded, 8 involved residents who had undergone our TeamSTEPPS-based communication training. The conversations were scored according to whether standard communication elements were performed, including patient, self and clinician identification; read-back confirmation, and clinician needs assessment. Additionally, we compared resident performance during actual intraoperative consultations with the pre- and post-training performance of residents who participated in our simulation-based communication training.
Results: Attending pathologists achieved an average score of 80% on completion of checklist items during recorded intraoperative consultations. Residents who had undergone communication training scored an average of 84%. Non-trained residents scored an average of 66%. Though trained residents outperformed attendings and untrained residents on all checklist items, their overall performance during actual intraoperative consultations was lower than during their simulation-based assessment post-training (84% and 94%, resp.) and higher than their initial baseline assessment pre-training (77%).
Conclusions: Effective delivery of pathology results can be as important as an accurate diagnosis in the intraoperative setting. Miscommunications may be reduced by ensuring that basic introduction, content and immediate acknowledgement is routinely performed. Simulated resident-clinician communication training modules improve resident communication skills as measured by both post-training simulation testing and evaluation of actual intraoperative consultations.
Category: Quality Assurance
Monday, March 4, 2013 2:30 PM
Proffered Papers: Section G, Monday Afternoon