From Communication Skills to Skillful Communication: A Longitudinal Integrated Curriculum for Critical Care Medicine
Amanda L Roze des Ordons1, Christopher J Doig, Philippe Couillard
1A.L. Roze des Ordons is clinical assistant professor, Department of Critical Care Medicine and Division of Palliative Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.C.J. Doig is professor, Department of Critical Care Medicine and Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.P. Couillard is clinical assistant professor, Department of Critical Care Medicine and Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.J. Lord is clinical associate professor, Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Problem:
Communication with patients and families in critical care medicine (CCM) can be complex and challenging. A longitudinal curricular model integrating multiple techniques within classroom and clinical milieus may facilitate skillful communication across diverse settings.
Approach:
In 2014-2015, the authors developed and implemented a curriculum for CCM fellows at the Cumming School of Medicine, University of Calgary, to promote the longitudinal development of skillful communication. A departmental needs assessment informed curriculum development. Five 4-hour classroom sessions were developed: basic communication principles, family meetings about goals and transitions of care, discussing patient safety incidents, addressing conflict, and offering organ donation. Teaching methods-including instructor-led presentations incorporating a consistent framework for approaching challenging conversations, simulation and clinical practice, and feedback from peers, trained facilitators, family members, and clinicians-supported integration of skills into the clinical setting and longitudinal development of skillful communication. Seven fellows participated during the first year of the curriculum.
Outcomes:
CCM fellows engaged enthusiastically in the program, commented that the framework provided was helpful, and highly valued the opportunity to practice challenging communication scenarios, learn from observing their peers, and receive immediate feedback.
Next Steps:
More detailed accounts of fellows', patients', and family members' experiences will be obtained to guide curricular development. The curriculum will be expanded to involve other members of the multidisciplinary intensive care unit team, and faculty education initiatives will be offered to enhance the quality of the feedback provided. The impact of the curriculum on initial skill development, retention, and progression will be assessed.
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