Communication Training for Medical Residents: A Mixed-Methods OSCE Pilot of CONVERSA LATAM

ObjectivesSerious-illness communication training is well established in North America and Europe but few culturally adapted programmes have been formally evaluated in Latin America. We evaluated behavioural change and perceived shifts in practice following Core CONVERSA LATAM, a short regionally adapted curriculum delivered to first-year residents in Chile.MethodsSingle-group convergent mixed-methods pilot at the Pontificia Universidad Católica de Chile. Nine first-year residents in oncology and geriatrics completed pre- and post-course Objective Structured Clinical Examinations (OSCEs) with two scenarios (a patient expressing mistrust; a family member hoping for a miracle), framed by a 7.5-hour course. Performance was scored on an eight-domain instrument adapted from the Gap-Kalamazoo assessment by self, standardized patients and faculty. The qualitative strand comprised 108 written feedback and self-reflection entries, analysed by reflexive thematic analysis. Strands were integrated through a joint display.ResultsNine residents (4 women, 5 men) completed the curriculum. Total OSCE scores improved across rater types: self (mean change 25.6, 95% CI 19.4-31.7), standardized patient (22.7, 14.6-30.7) and faculty (42.3, 31.8-52.9), all P <.01; as an exploratory pilot, these comparisons were not corrected for multiple testing. Variability between residents narrowed at post-test, suggesting convergence toward a shared baseline. Five qualitative themes traced a shift from information-heavy to deliberate, patient-centred practice: responding to emotions; responding to mistrust; integrating values and beliefs; delivering prognosis; and making recommendations rooted in patients' goals.ConclusionsA short, culturally adapted, OSCE-anchored curriculum produced measurable behavioural change and perceived shifts in practice, with consistent gains across three independent raters and a parallel qualitative trajectory. Mixed-methods OSCE evaluation offers a feasible model for serious-illness communication training in settings where formal training is still emerging.