Improving Communication Skills of Residents Using Family Meeting Simulation Exercises

Area of Science:

• Medical Education
• Communication Skills Training
• Patient-Physician Communication

Background:

• Effective communication is crucial for delivering serious news to patients and families.
• Medical residents require enhanced skills for sensitive discussions, particularly in intensive care settings.
• Kolb's experiential learning theory provides a framework for developing communication competencies.

Purpose of the Study:

• To evaluate the impact of a simulation-based curriculum on residents' communication skills and confidence in delivering bad news.
• To assess the effectiveness of a mini-lecture and simulation intervention using Kolb's experiential learning theory.
• To improve residents' ability to conduct family meetings during Medical Intensive Care Unit (MICU) rotations.

Main Methods:

• An educational intervention was conducted with 26 internal medicine residents during their MICU rotation.
• Residents participated in a simulated family meeting (Mini-Clinical Evaluation Exercise - Mini-CEX) using untrained actors and a SPIKES protocol evaluation tool.
• A 30-minute interactive lecture on the SPIKES protocol was delivered, followed by a post-didactic Mini-CEX and pre/post-intervention surveys on comfort levels.

Main Results:

• Residents reported significantly increased comfort in facilitating end-of-life family meetings post-intervention (p < 0.001).
• Mini-CEX scores showed significant improvement across all 20 SPIKES items (p < 0.001), with a notable increase in overall scores (24.7 to 46.1, p < 0.001).
• Both International Medical Graduates (IMG) and US Medical Graduates (USMG) demonstrated significant score improvements in all SPIKES components.

Conclusions:

• A combination of simulated family meetings and a concise didactic lecture on the SPIKES protocol effectively enhances residents' skills and confidence.
• The intervention successfully improved residents' proficiency in leading family meeting discussions, a critical aspect of medical care.
• This educational approach, grounded in experiential learning, offers a valuable model for communication skills development in postgraduate medical training.