Improve Doctor-Patient Communication with Online Modules and Video Simulations

Simulations provide students with:

  • Experiential learning opportunities
  • Content at the point in time when they are faced with a new decision, thus increasing its relevance and the students' motivation to acquire this new knowledge

Challenge

During surgical residency training, time is at a premium as residents are full-time physicians who also care for patients. One of the most important competencies is the development of interpersonal communication skills and professionalism. Yet, when time is short, necessary training can easily fall by the wayside.

The Department of General Surgery in the University of Minnesota Medical School (UMMC) has used simulated encounters with trained actors who played family members for many years. The residents learned how to lead an end-of-life family care conference and how to disclose a medical error. However, those who performed poorly on simulated tests did not receive enough guidance on how to improve.

Constance Schmitz, Department of Surgery, explains: "We needed some sort of intervention to help them really see and hear how to communicate more effectively with family members whose loved ones were in surgical intensive care units."

Solution

A team that included medical faculty, a Ph.D. educator, and Academic Technology Support Services (ATSS) staff collaborated to create an asynchronous, independent learning intervention that could be paired with brief, face-to-face teaching sessions. The intervention featured modules that residents could access wherever and whenever they needed: on the floor, at various hospitals, or at home.

Ten modules were created: five modules focusing on end of life, and five detailing medical error disclosure. The faculty drafted storyboards, provided text and visual content for the PowerPoint presentations in the modules, and narrated the recordings.

Screenshot of end of life module

The modules guide residents through the process: preparing for the conference, breaking bad news, responding to family emotions, creating care plans, and closing the meeting. Because residents participating in these simulations had been rated by trained examiners (family members, surgeons, and ICU nurses), the content experts and designers were able to select both effective and less effective examples of communication.

Outcome

"The faculty have been extremely excited about the course, and buy-in has been fantastic," says Schmitz. In Spring of 2014, they received a national award from the Association of Surgical Education and the Association of Program Directors in Surgery. The faculty research team is studying the effectiveness of the online modules and face-to-face sessions with medical residents.