Improving Communication With Surrogate Decision-Makers: A Pilot Initiative.

Area of Science:

• Medical Education
• Communication Skills Training
• Patient Surrogate Decision-Making

Background:

• Difficult conversations in healthcare frequently involve physicians and patient surrogates.
• Ineffective communication can increase surrogate anxiety and guilt, and contribute to physician burnout.

Purpose of the Study:

• To assess the effectiveness of an experiential learning workshop designed to improve resident physician communication skills with surrogate decision-makers.
• To evaluate the feasibility of implementing such training within a clinical setting.

Main Methods:

• Internal medicine residents participated in a 6-hour communication skills workshop.
• Objective Structured Clinical Examinations (OSCEs) with standardized actors assessed skills before and after the workshop.
• Faculty and simulated surrogates evaluated communication using the Gap Kalamazoo Consensus Statement Assessment Form.

Main Results:

• A significant improvement in post-workshop OSCE scores compared to pre-workshop scores (P < .001).
• The majority of residents reported increased confidence in their communication abilities after the workshop.
• The intervention demonstrated a moderate effect size (r = 0.52).

Conclusions:

• Focused interventions, like this workshop, enhance resident communication skills for surrogate decision-making.
• The study highlights the practicality of integrating OSCEs and simulated patient encounters into clinical training environments.
• The workshop shows promise for improving physician-surrogate interactions and potentially mitigating associated distress.