Joyce Barbara L, Scher Eric, Steenbergh Timothy, Voutt-Goos Mary J
J Grad Med Educ. 2011 Dec;3(4):524-8. doi: 10.4300/JGME-D-10-00233.1.
We describe a collaboration between the graduate medical education office and the Henry Ford Health System's Office of Clinical Quality and Safety to create an institution-wide communication skills curriculum pertinent to the institution's safety and patient- and family-centered care initiatives.
A multidisciplinary committee provided oversight for the curriculum design and used sentinel event and other quality and safety data to identify specific target areas. The curriculum consisted of 3 courses: "Informed Consent," "Sharing Bad News," and "Disclosure of Unanticipated Events." Each course included 3 components: a multimedia online module; small group discussions led by the program director that focused on the use of communication scripts; and 2 objective structured clinical examinations (OSCEs) requiring residents to demonstrate use of the communication scripts. All first-year residents (N = 145) and faculty (N = 30) from 20 residency programs participated in this initiative. Evaluation of the residents consisted of a self-assessment; the standardized patients' assessment of the residents' performance; and faculty assessment of resident performance with verbal feedback.
Survey data showed that residents found the courses valuable, with residents identifying communication scripts they would use in clinical settings. Focus groups with faculty highlighted that the resident debriefing sessions provided them with insight into a resident's communication skills early in their training.
Our institutional curriculum was developed in a collaborative manner, and used an evidence-based approach to teach communication skills relevant to institutional safety and quality initiatives. Other institutions 5 wish to adopt our strategy of departmental collaboration and alignment of resident education with institutional initiatives.
我们描述了研究生医学教育办公室与亨利·福特医疗系统临床质量与安全办公室之间的合作,以创建一个全机构范围内与该机构的安全以及以患者和家庭为中心的护理计划相关的沟通技能课程。
一个多学科委员会对课程设计进行监督,并使用警戒事件以及其他质量与安全数据来确定具体的目标领域。该课程由3门课程组成:“知情同意”“告知坏消息”和“意外事件的披露”。每门课程包括3个部分:一个多媒体在线模块;由项目主任主持的小组讨论,重点是沟通脚本的使用;以及2次客观结构化临床考试(OSCE),要求住院医师展示沟通脚本的使用。来自20个住院医师培训项目的所有一年级住院医师(N = 145)和教员(N = 30)参与了这项计划。对住院医师的评估包括自我评估;标准化患者对住院医师表现的评估;以及教员通过口头反馈对住院医师表现的评估。
调查数据显示住院医师认为这些课程很有价值,他们确定了会在临床环境中使用的沟通脚本。与教员进行的焦点小组讨论强调,住院医师汇报会让他们在培训早期就深入了解住院医师的沟通技能。
我们的机构课程是以合作的方式开发的,并采用循证方法教授与机构安全和质量计划相关的沟通技能。其他机构希望采用我们部门合作以及使住院医师教育与机构计划保持一致的策略。