Improving the Communication Skills of Internal Medicine Residents Using Family Meeting Simulation Exercises in the Medical ICU

Abstract Objective To examine whether resident communication skills evaluated through patient satisfaction surveys demonstrate evidence of decline through the 3 years of internal medicine residency. Methods Data for this study were collected retrospectively from a database of patient satisfaction surveys completed for internal medicine residents at different levels of training. Patient satisfaction was measured with the Aggregated EVGFP (excellent, very good, good, fair, or poor) questionnaire recommended by the American Board of Internal Medicine. Results Over a span of 5 years (2005–2009), a total of 768 patient rating forms were completed for 67 residents during their 3 years of residency training. In postgraduate year (PGY)–1, the residents had a mean satisfaction rating of 4.33 ± 0.48 compared to a mean rating of 4.37 ± 0.45 in their PGY-3 year. Analysis of variance indicated no significant difference by PGY level. Conclusion Our findings demonstrate that resident communication skills and patient satisfaction do not decline during the 3 years of residency. This is contrary to our hypothesis that patient satisfaction would worsen as residents progressed through training.

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Teaching residents how to break bad news: piloting a resident-led curriculum and feedback task force as a proof-of-concept study

BMJ Simulation and Technology Enhanced Learning ◽

10.1136/bmjstel-2021-000897 ◽

2021 ◽

pp. bmjstel-2021-000897

Author(s):

Joseph Sleiman ◽

David J Savage ◽

Benjamin Switzer ◽

Colleen Y Colbert ◽

Cory Chevalier ◽

...

Keyword(s):

Internal Medicine ◽

Communication Skills ◽

Task Force ◽

Educational Innovation ◽

Field Testing ◽

Bad News ◽

Two Phase ◽

Academic Medical Centre ◽

Internal Medicine Residents ◽

Survey Results

BackgroundBreaking bad news (BBN) is a critically important skill set for residents. Limited formal supervision and unpredictable timing of bad news delivery serve as barriers to the exchange of meaningful feedback.Purpose of studyThe goal of this educational innovation was to improve internal medicine residents’ communication skills during challenging BBN encounters. A formal BBN training programme and innovative on-demand task force were part of this two-phase project.Study designInternal medicine residents at a large academic medical centre participated in an interactive workshop focused on BBN. Workshop survey results served as a needs assessment for the development of a novel resident-led BBN task force. The task force was created to provide observations at the bedside and feedback after BBN encounters. Training of task force members incorporated video triggers and a feedback checklist. Inter-rater reliability was analysed prior to field testing, which provided data on real-world implementation challenges.Results148 residents were trained during the 2-hour communications skills workshop. Based on survey results, 73% (108 of 148) of the residents indicated enhanced confidence in BBN after participation. Field testing of the task force on a hospital ward revealed potential workflow barriers for residents requesting observations and prompted troubleshooting. Solutions were implemented based on field testing results.ConclusionsA trainee-led BBN task force and communication skills workshop is offered as an innovative model for improving residents’ interpersonal and communication skills in BBN. We believe the model is both sustainable and reproducible. Lessons learnt are offered to aid in implementation in other settings.

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Abstract #789520: Transgender Health Care: Evaluation of the Perception of Competence and Comfort Level Among Internal Medicine Residents

Endocrine Practice ◽

10.1016/s1530-891x(20)39432-5 ◽

2020 ◽

Vol 26 ◽

pp. 179

Author(s):

Beatriz Martinez Quintero

Keyword(s):

Internal Medicine ◽

Health Care ◽

Comfort Level ◽

Transgender Health ◽

Internal Medicine Residents ◽

Health Care Evaluation ◽

Care Evaluation

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Learning Electrocardiogram Interpretation: Insights from Residents and a Proposed Solution in an Observational Study (Preprint)

10.2196/preprints.19645 ◽

2020 ◽

Author(s):

Mohammad Alakchar ◽

Abdisamad M. Ibrahim ◽

Mohsin Salih ◽

Mukul Bhattarai ◽

Nitin Tandan ◽

...

Keyword(s):

Internal Medicine ◽

Correlation Coefficient ◽

Online Survey ◽

Cross Sectional Study ◽

Cross Sectional ◽

Resident Attitudes ◽

Internal Medicine Residents ◽

Life Threatening ◽

Degree Of Participation ◽

Electrocardiogram Interpretation

BACKGROUND Interpretation of electrocardiograms (EKG) is an essential tool for every physician. Despite this, the diagnosis of life-threatening pathology on EKG remains suboptimal in trainees. The purpose of this study is to study resident attitudes and behaviours towards EKGs, and describe an innovative way to teach EKGs. OBJECTIVE Study attitudes and behaviours towards EKGs. Describe an innovative way to teach EKGs. METHODS Design: An observational cross-sectional study through an anonymous online survey of resident attitudes and comfort with EKG interpretation. This was followed by creation of a WhatsApp group for discussion and interpretation of EKGs with peers. At the end of the day, the official EKG interpretation was posted. Setting: Internal medicine residency at Southern Illinois University. Participants: Internal medicine residents Interventions: Creation of WhatsApp group to aid with EKG interpretation Measurements: A 17 item questionnaire, followed by detection of degree of participation in a WhatsApp group. RESULTS Forty-one out of 63 residents (65%) completed the survey. 85% of respondents thought that an interactive way to teach EKGs is the best method of teaching, and 73% did not feel confident interpreting EKGs. 30% often rely on automated EKG interpretation. Further analysis indicated that PGY-1 residents reported ordering fewer EKGs (correlation coefficient -0.399, p = 0.012) and were uncomfortable diagnosing QT prolongation on an EKG (correlation coefficient -0.310, p = 0.049). Residents in the third or greater year of training ordered more EKGs (correlation coefficient 0.379, p = 0.015), less frequently relied on the computer for EKG diagnosis (correlation coefficient 0.399, p = 0.010), and were comfortable diagnosing an acute myocardial infarction and atrial arrhythmias. CONCLUSIONS In conclusion, most IM trainees do not feel comfortable interpreting EKG, however, this does improve with PGY year. WhatsApp is a possible platform for teaching EKGs.

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