Improving Resident-Patient Communication: a CQI Initiative

Communication represents one of the core competencies for all ACGME programs, but it is commonly taught by modeling (i.e. osmosis) by attending physicians with little training in educating residents about successful patient physician communication. This belies the fact that the average clinician sees an average of x thousand patients during his or her career. Without clear guidance on communication learners commonly believe "good" communication is one that leaves them feeling satisfied and a "bad" communication is one that leaves them feeling dissatisfied, which may not be true from the patient's perspective. The attending physician observed consistent improvement in the elements of communication as well as the residents during the 2016-2017 academic year. Attending KEEC-A scores trended toward improvement after intervention, but this was not statistically significant. This differed compared to the prior academic year when the attending rated the residents higher than they each rated themselves. The video intervention was initially a bit uncomfortable for the residents, but was consistently reported to be an excellent teaching and feedback tool. A four hour didactic session including education about physician-patient communication, 1-2 simulated patient encounters, and review of these encounters will now be included for the upcoming academic year. We are also reviewing expansion of this process to other sites. Resident self-evaluation scores on the KEEC-A improved after intervention (mode & mean). Attending KEEC-A scores improved after intervention, but this trend was not statistically significant.