Building De-escalation Communication Skills With Surgical Residents Utilizing Simulated Patient Methodology.

Area of Science:

• Medical Education
• Surgical Training
• Communication Skills

Background:

• Surgery residents face high-stress patient encounters, risking well-being and care quality.
• De-escalation communication training is crucial for managing patient aggression but not standard in surgical residency.
• Exposure to patient aggression negatively impacts resident well-being and patient safety.

Purpose of the Study:

• To evaluate the effectiveness of simulation-based de-escalation communication training for general surgery residents.
• To assess improvements in residents' ability to manage patient conflict and aggression.
• To determine the impact of training on resident communication skills in simulated high-stress scenarios.

Main Methods:

• A simulation-based de-escalation training program was implemented for Post-Graduate Year-1 and Year-2 general surgery residents.
• Training involved simulated patient cases with iterative debriefs and feedback sessions.
• De-escalation skills were assessed using the Essential Elements of Communication-Global Rating Scale and English-modified De-escalating Aggressive Behavior Scale.

Main Results:

• Residents reported a significant increase in attempted de-escalation techniques per encounter (P=0.02).
• Essential Elements of Communication-Global Rating Scale scores improved significantly within cases (P<0.01).
• English-modified De-escalating Aggressive Behavior Scale scores showed significant improvement throughout the simulation (P=0.003).

Conclusions:

• Simulation-based de-escalation training effectively enhanced surgical residents' communication and conflict management skills.
• Iterative debriefs and feedback were key components in skill development.
• This curriculum provides a framework for integrating essential de-escalation training into surgical residency programs to improve patient care and safety.