ABSTRACT #44

Communication Skills Training Curriculum Needs Assessment For Internal Medicine Resident

Sonal Gandhi, Yosef Joseph Rene Amel Riazat Kesh, Fionnuala Crowley, Vasundhara Singh, Noelle Javier

PURPOSE AND GOALS: ACGME recognizes interpersonal and communication skills as one of the six core competencies for internal medicine residency training. Studies have shown increased patient, family, and clinician satisfaction and better healthcare outcomes with effective communication. Despite compelling evidence suggesting the utility of a formal curriculum, it is often a hidden curriculum, acquired by observation and self-study. This project’s aim is to determine the perceived need for a formal curriculum by internal medicine residents and how to effectively address it.

METHODS: We created an anonymous survey for all internal medicine residents at various levels and assessed the following domains: prior training in communication skills for patients with serious illnesses, the frequency of difficult conversations, the level of perceived confidence in delivering serious news and complex goals of care discussion, and the importance of having a formal communication skills training.

EVALUATION PLAN: The results of needs assessment survey as outlined below will guide our didactics and training sessions

SUMMARY OF RESULTS: There were 52 completed responses. The breakdown of responses are as follows: 48% PGY1; 25% PGY2; and 27% PGY3. Only a third (31%) of respondents reported any history of formal instruction in communication skills. The overwhelming majority (96%) reported having to deliver serious news and have complex goals of care and end-of-life discussions with patients at least once (the most common response being >10 times).

Most respondents (62% and 73% respectively) reported having a confidence of 3/5 or lower (on a Likert scale with 5 as most confidence) in having both types of discussions. 93% of respondents agreed that communication skills training is essential. The most popular areas of further communication training included establishing goals of care and discussing grim or uncertain prognoses

REFLECTIVE CRITIQUE: Our results demonstrate a clear unmet need for a formalized curriculum on difficult end-of-life conversations including prognostication. The next steps in the project will be recruiting and training volunteer communication champions and designing a series of case-based small-group teaching and simulation sessions for residents during academic half-days with a pre-test and post-test assessment.