Are we getting through? A national survey on the CanMEDS communicator role in urology residency

Physician communication skills are paramount to patient satisfaction and are linked to important clinical outcomes. Although well-codified in the Royal College of Physicians and Surgeons of Canada (RCPSC) CanMEDS program, the knowledge, skills, and assessment of communication skills in surgical specialty training are rarely addressed. We assess Canadian urology residents' experience of and attitudes towards this crucial competency in training and practice.

An anonymous, cross-sectional, self-reported questionnaire was administered to all final year urology residents in Canada from 2 consecutive graduating years (2010 and 2011). A closed-ended 5-point Likert scale was used to assess familiarity with the concept of the RCPSC Communicator role and its application and importance to training and practice. Descriptive and correlative statistics were used to analyze the responses, such as the availability of formal training and resident participation in activities involving health communication. For ease of reporting, an agreement score was created for those responding with "strongly agree" and "agree" on the Likert scale.

There was a 100% response rate from the chief residents for both of the 2 years of the survey (n = 58). When questioned about the RCPSC CanMEDS roles, only 45% could identify the correct number of roles, and only 19% could correctly list all 7 roles. However, most residents were well aware of the Communicator role (90% agreement [mean 4.47 ± 0.78]), and most agreed that it plays an important role during training and future practice (83% [4.16 ± 0.84], 90% [4.39 ± 0.84] respectively). This is in stark contrast to perceived formal training. Only 31% (3.00 ± 1.04) agreed that formal training or mentorship in communication was available at their institution, and only 38% (3.14 ± 1.19) felt that communication had been formally addressed during explicit sessions. Despite most of the respondents agreeing they had a significant mentor/role model to emulate regarding communication skills, only 48% believed that faculty frequently addressed communication during clinical learning experiences.

Despite knowledge and acceptance of the importance of the Communicator role, there is a perceived lack of formal and explicit training in this essential non-medical expert role of urology residency. It would seem apparent from this needs assessment that there may be an opportunity to coordinate efforts to ensure formal instruction and evaluation in our training programs.