Department of Surgery, 6887Virginia Commonwealth University Health System, Richmond, VA, USA.
Office of Assessment, Evaluation and Scholarship, 6886Virginia Commonwealth University School of Medicine, Richmond, VA, USA.
Am Surg. 2023 Mar;89(3):440-446. doi: 10.1177/00031348211030458. Epub 2021 Jul 6.
The COVID-19 pandemic resulted in a sudden increase in the need to effectively use telehealth in all realms of health care communication, including the delivery of bad news.
A single arm, unblinded, feasibility study was performed at a tertiary care center located in Central Virginia to explore the value and utility of providing a telehealth training program based on SPIKES to teach surgical residents and faculty best practice for disclosing difficult news via video-mediated communication (VMC). Surgical interns (categorical and preliminary), surgical residents, and surgical faculty from General, Neuro, Pediatric, Plastics, Oncology, Urology, and Vascular surgical specialties were recruited via email to voluntarily participate in a telehealth simulation-based workshop, with 33 surgical learners participating in the training and 28 completing evaluation surveys.
Only six respondents (22%) indicated they had prior formal training on telehealth communication with patients or families, while 13 (46%) said they had prior experience giving bad news via telehealth. Comments about improving the training focused on providing more scenarios to practice and more time for feedback. Overall, 25 learners (86%) agreed the activity was a valuable learning experience and the majority (61%) of responses were positive for future use of telehealth for breaking bad news.
Practicing communication skills with VMC was found to be valuable by surgical interns, residents, and faculty. Formal training should be provided for surgeons at every stage of training and practice to improve skill in the delivery of bad news to patients and their families.
COVID-19 大流行导致医疗保健沟通的各个领域，包括传递坏消息，都突然需要有效利用远程医疗。
在弗吉尼亚州中部的一家三级保健中心进行了一项单臂、非盲、可行性研究，以探索提供基于 SPIKES 的远程医疗培训计划的价值和效用，该计划旨在教授外科住院医师和教师通过视频介导的交流（VMC）披露困难消息的最佳实践。通过电子邮件招募普通外科、神经外科、儿科外科、整形外科、肿瘤外科、泌尿科和血管外科专业的住院医师（普通和初级）、住院医师和外科教员自愿参加远程医疗模拟为基础的研讨会，共有 33 名外科学习者参加了培训，28 人完成了评估调查。
只有 6 名受访者（22%）表示他们之前接受过关于通过电话与患者或家属进行远程医疗沟通的正式培训，而 13 名受访者（46%）表示他们之前有过通过远程医疗传递坏消息的经验。关于改进培训的意见集中在提供更多的场景来练习和更多的反馈时间。总体而言，25 名学习者（86%）认为该活动是一次有价值的学习体验，大多数（61%）的受访者对未来使用远程医疗来传递坏消息持积极态度。
通过 VMC 练习沟通技巧被外科住院医师、住院医师和教员认为是有价值的。应在每个培训和实践阶段为外科医生提供正式培训，以提高向患者及其家属传递坏消息的技能。
