A Workshop in Physician-Patient Communication for Anesthesiology Trainees

Although abundant literature demonstrates the importance of effective physician-patient communication, most research and teaching models in this area are based on a primary care setting, and may not apply to procedural specialties. Some research demonstrates that patients perceive their surgeons' and anesthesiologists' communication skills to be less effective than those of primary care specialists. In order to improve the effectiveness of anesthesiology trainee communication skills and simultaneously address the new ACGME general competency requirements pertaining to such skills, faculty from the Departments of Anesthesiology and Internal Medicine collaborated in the development of a workshop tailored to the needs of this group.

After reviewing the literature on physician-patient communication in primary care and in procedural specialties, we created and delivered a workshop.

The literature review revealed that although the essential communication skills are the same in primary care and procedural specialties, the anesthesia-patient interaction is unique because it is inherently brief, its function is to prepare for a procedure, not to diagnose and treat, and patient anxiety is generally high due to the imminent surgical procedure. We created a workshop by adapting the Bayer Institute for Health Communication's 4E Model to the anesthesia setting. This teaching model was chosen because it is based on literature that reflects both primary care and procedural settings, because it has been widely and successfully used in brief workshops to physicians, and because it achieves the overall goals of the course. They were 1) to teach the skills related to the essential elements for physician-patient communication and the functions of the pre-operative anesthesiologist-patient interaction and 2) to partially fulfill the ACGME general competency objectives. In addition to teaching the basic skills of the 4Es (Engage, Empathize, Educate and Enlist), specific examples, video cases, and role plays from the anesthesia setting were used to illustrate common problems in physician-patient communication.

Non-primary care specialties may need to tailor current physician-patient communication models to their setting in order to train residents in interpersonal and communication skills. Our proposal for a physician-patient communication workshop for anesthesiology trainees illustrates one way in which an existing teaching model can be adapted to meet the specific needs of a procedural specialty.