The Accreditation Council of Graduate Medical Education requires residency program directors ensure trainees can meet proficiency expectations in communication across the patient care continuum. However, a comprehensive compilation of methodologies and resources is unavailable to utilize when developing effective curricula.
A new analysis published in Academic Radiology discussed teaching techniques that can be utilized by program directors to incorporate communication education into curricula.
“These standards challenge program directors to address communication competencies within their training curricula, and to develop both educational resources and assessment tools for their residents,” wrote lead author David Sarkany, MD, MS-HPEd, at the Staten Island University Hospital Northwell Health, and colleagues. “Over time, numerous teaching resources and pedagogical approaches have materialized that target patient-related communication skills specifically for radiology. Currently, however, these tools are scattered independently throughout the literature, on various websites, and elsewhere.”
Here are three examples of how communication can be taught to radiology residents, taken from team’s analysis:
Used as a method to train future educators, the “microteaching” method allows for students to learn from each other in group settings. There are multiple steps to the process: pre-observation, observation, analysis, self-viewing and supervisory conference.
“In this age of reflective, active learning, microteaching allows the student teacher to learn by practicing and receiving feedback from a safe learning audience,” the authors wrote.
The authors noted that microteaching was implemented as part of a communication program for residents at Beth Israel Deaconess Medical Center in Boston. In the program, residents initiated and were recipients of enacted conversations; examples included a conversation with a family member after his loved one died from a contrast reaction and difficult workplace situations with fellow radiologists.
- Simulation-based Training
In this interactive training, radiologists are placed in various scenarios that require them to communicate with “patients” typically played by actors. A more complex method of simulation-based training utilizes computer-based modules that simulate cases with real interruptions in the reading room.
The University of Massachusetts Medical School in Worcester implemented a program using trained actors for simulation-based communications skills. The residents were videotaped working through different scenarios. The residents were evaluated using the Gap-Kalamazoo Communication Skills Assessment Form, a common method for assessing communication skills. Simulations were then repeated two weeks later to evaluate for improvement.
“These simulations provide hands-on experience practicing communication skills with opportunities for active, real-time feedback from a variety of potential sources, including actor/patients, trained communication specialists, and interdisciplinary coworkers,” the authors wrote.
- Mnemonics, Scripts and General Aids
Though mnemonics can be utilized by radiologists to review what to communicate, they are not necessarily utilized for how to communicate.
“General aids such as mnemonics, scripts and educational articles may be quick and accessible ways for residents to review key elements of professionalism and communication in patient encounters, although their effectiveness has not been specifically validated,” the authors wrote. “More importantly, absent an experiential component, they are not likely to help trainees cultivate the improvisational, relational skills necessary to navigate difficult conversations that entail complex emotional and cognitive dynamics. This is where simulation is most beneficial.”
A mnemonic suggested specifically for radiologists is “RADPED,” which stands for report, ask, discuss, perform procedure, exam distraction techniques and discuss. This device is meant to help patients remember what important things to discuss during “an imaging encounter.”