Together again: a community redefining residency education

Introduction: Goals-of-care and advanced care planning conversations are associated with high-quality care for patients with serious illness.However, these important conversations often create distress among patients, clinicians, and healthcare teams.Moreover, although residents are frequently responsible for leading these conversations, they report feeling uncomfortable and unprepared, and desire more direct observation and feedback to master patient-centered communication skills.Method: We developed a series of 3-hour virtual communication simulation-based workshops for secondyear internal medicine (IM) residents (n = 81) facilitated by fellows and staff.Each workshop provided opportunities for virtual simulated practice of a specific set of patientcentered communication skills (e.g., listening skills, exploring illness understanding, responding to emotions).Prior to each workshop, residents completed preparatory reflection exercises and videos.During each workshop, we split residents into small groups in breakout rooms with 1-2 trained staff or fellow facilitators.In the first session, the facilitators played the role of the simulated patient, while in subsequent workshops, a standardized patient (SP) was used.Residents took turns engaging in simulated conversation with the SP, focusing on specific communication techniques taught, with time-outs to receive and apply immediate coaching and constructive feedback from facilitators.Facilitated debriefs with guided feedback and self-and group-reflection followed. Conclusion: Resident evaluations were highly favourable.Residents strongly valued deliberate simulation-based practice of communication skills in emotionally complex situations, and perceived a strong benefit of direct observation and real-time feedback from coaches and peers, with the opportunity to apply coaching in real time.They described enhanced confidence and knowledge of patient-centered communication skills (e.g., formulating verbal reflections, the use of silence, diffusing tensions) and all desired additional virtual and in-person simulationbased practice.Simulation-based virtual workshops may offer a novel way to enhance patient-centered communication skills.

Abstract licence: CC BY-NC-ND

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