Improved Pathology Resident Performance in Critical Value Communication Using Simulation Based Communication Training
Suzanne Dintzis, Sheila Mehri, Jennie Struijk, Dan Luff, Mara Rendi, Stephen Raab. University of Washington Medical Center, Seattle, WA
Background: JCAHO reports that ineffective communication is a root cause for nearly 66 percent of all sentinel events reported; however, pathology residents receive little to no training in communication skills. We developed communication modules using simulated clinician-pathologist interactions, interactive group training in communication strategies and tools and checklists of 15-20 elements for resident performance evaluation.
Design: Trained simulated clinicians communicated with 21 residents through phone calls using scripted scenarios involving critical value handoffs. Scenarios were designed to include varying communication skills ranging from basic diagnosis, conflict resolution and error disclosure. Residents attended interactive didactic sessions based on TeamSTEPPS, a nationally implemented evidence-based strategy used for improving communication and teamwork skills among health care professionals. Audio recordings of their interactions with simulated clinicians were provided to them to enhance performance feedback.
Results: Performance on individual checklist basic elements such as patient, self and clinician identification and check-backs improved from an average score of 77% to 94% after simulation training. In addition, resident performance demonstrated improvement on more challenging checklist elements such as problem solving, clinician needs assessment and conflict resolution, improving from an average score of 76% to 87% after training. Overall baseline resident performance on all checklist elements improved from an average score of 75% to 93% after course completion. Residents subjectively reported increased confidence in their ability to communicate in difficult situations post training and reported using TeamSTEPPS strategies in actual critical value communications.
Conclusions: Simulated resident-clinician communication scenarios provide residents with real time performance evaluation and improve resident communication skills as measured by both objective and subjective criteria. Addition of formal communication training in residency would benefit training programs and decrease the incidence of less than optimal hand-offs.
Monday, March 4, 2013 8:30 AM
Proffered Papers: Section H1, Monday Morning