The Surgical Resident Communication Experience: A Prospective Observational Needs Assessment

Area of Science:

• Medical Education
• Surgical Communication
• Healthcare Professional Training

Background:

• Effective communication is crucial for surgeons, encompassing patient consent, family discussions, care coordination, and demonstrating competence.
• The most challenging communication tasks for surgical residents and optimal training priorities remain unidentified.
• No prior studies prospectively assessed surgical residents' communication activities, comfort, and competence.

Purpose of the Study:

• To prospectively observe and analyze surgical residents' communication encounters.
• To identify challenging communication tasks and themes experienced by residents at different training levels.
• To inform the development of targeted communication training curricula for surgical residents.

Main Methods:

• A prospective observational study involving 23 surgical residents and 300 recorded communication encounters.
• Data collection included encounter details (location, duration, topic), resident reflections, and researcher observations.
• Qualitative analysis of resident comments and field notes to identify common themes and experiences.

Main Results:

• Interns reported lowest comfort with unfamiliar protocols, non-standardized care, interpreter tech, and electronic interruptions.
• More experienced residents faced frustrations with inter-professional coordination and unclear processes.
• While high-stakes patient/family discussions were challenging, systemic issues (technology, colleagues) caused more distress across all levels.

Conclusions:

• Training should address complex scenarios like negotiating clinical plans, managing consults, and supporting families under time pressure.
• Systemic and interpersonal communication challenges, rather than direct patient interactions, present greater difficulties for residents.
• Further longitudinal, multi-institutional studies are needed to refine communication training needs.