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Improving Serious Illness Communication Skills in Obstetrics and Gynecology Residents: A Pilot Study
Monica J Janke1, Laura Taylor2, Michael P Mendez3
1Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, University of Michigan, Ann Arbor, Michigan 48109.
Objective:
Delivering serious news to patients and their families is a crucial skill for obstetrician-gynecologists. However, effective communication practices are seldom taught during medical training and limited educational strategies exist for resident-level trainees. We aimed to implement a pilot course in serious illness communication for obstetrics and gynecology (OBGYN) residents and assess self-perceived preparedness in key skills before and after the course.
Design:
We created an OBGYN-specific serious illness communication course based on the nationally recognized VitalTalk framework. The course included a 1-hour didactic and a 2-hour small group live-action simulation. Participants were surveyed before and after the course to assess their comfort with delivering serious news and preparedness in performing key communication skills, using a 5-point Likert scale. Pre- and postcourse responses were analyzed using the Wilcoxon signed-rank test.
Setting:
A large academic medical center in the Midwest United States.
Participants:
Twenty-five ACGME-accredited OBGYN residents during the 2023-2024 academic year participated in the course and completed pre- and postcourse survey assessments.
Results:
After course completion, residents felt significantly more comfortable with delivering serious news, with median ratings increasing from 4.0 (IQR 2.0-4.0) to 5.0 (IQR 4.0-5.0, p = 0.001). Residents' median rating of preparedness to perform key communication skills significantly improved in all domains, including: conveying serious news (p < 0.001) and prognosis (p < 0.001), recognizing emotion and responding with empathy (p < 0.001), leading a family meeting (p = 0.001), managing conflict (p < 0.001), and responding to patients who deny the seriousness of their illness (p < 0.001) or who want treatments that are not indicated (p < 0.001).
Conclusions:
Implementing an OBGYN-focused course that improves resident preparedness for and comfort with delivering serious news is feasible. Equipping residents with compassionate and effective communication skills should be integral to OBGYN residency training.
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