Implementation of a skills-based virtual communication curriculum for medical students interested in surgery.

Background: Communication skills are essential to providing patient-centered care. The need for standardized communication skills training is at the forefront of medical school and residency education. We aimed to design and implement a curriculum teaching virtual communications skills to medical students. The purpose of this report is to describe our experience and to offer guidance for training programs developing similar curricula in the future. Methods: The curriculum was presented in weekly modules over 5 weeks using Zoom technology. We focused on proven strategies for interacting with patients and other providers, adapted to a virtual platform. Skill levels during role-play were assessed by the Simulated Participants and students observing the simulation using the 14-item, physician specific Communication Assessment Tool (CAT). The primary outcome of the CAT is the percentage of "excellent" for each item ranked both years. Participants provided feedback on what worked well or how the module could be improved in open-ended responses. Results: Twenty-eight and 25 students registered for the course in Year 1 and Year 2, respectively. Students' post-session confidence in their ability to perform target skills was statistically higher than their pre-session scores in most sessions. Modules with the lowest pre-session confidence for both years were "Disclosing a Medical Error" and "Responding to Patient Bias." The mean percentage of students receiving "excellent" scores on individual CAT items ranged from 5 to 73% over the course of both years. Verbal and written feedback in Year 1 provided direction for the curriculum developers to improve the course in Year 2. Conclusions: Developing and implementing a new education curriculum is a complex process. We describe an intensive curriculum for medical students as we strive to allow students extra "clinical" time during COVID-related restriction. We believe continued focus on patient and family communication skills will enhance patient care. Supplementary Information: The online version contains supplementary material available at 10.1007/s44186-022-00054-9.

Managing Patient Bias: Teaching Residents to Navigate Racism and Bias in the Workplace.

BACKGROUND: Racial inequities are infused within American society and healthcare systems; notable events in 2020 highlighted an urgent need for change. Many organizations were inspired to examine the impacts of systemic racism. The impact of physician bias on patient experiences and outcomes has been well documented; biased patient behavior is now becoming more openly discussed. In response to the current climate and painful effects of discrimination on healthcare and providers, we aimed to provide training for our surgical residents to more comfortably respond to bias in the workplace. METHODS: We designed and piloted a simulation-based communication module focused on managing bias with medical students. We incorporated feedback received from students, facilitators, faculty, and simulated patients (SPs) to create an anti-bias workshop for surgical residents. Additionally, we worked with the pediatric and emergency departments to develop training videos depicting bias incidents, standardize debriefing processes, and implement anti-bias workshops for their residencies. RESULTS: Twenty students participated in the medical student pilot session. Student confidence increased in target skills; many noted this was their first exposure to the topic in a medical school course, and first opportunity to practice these skills. Sixteen surgical residents participated in an in-person module; learners self-identifying as "completely confident" increased in number significantly for "determining whether to respond" (p = 0.023), "knowing how to ensure follow up" (p = 0.041), and "self-care following an event" (p = 0.023). CONCLUSION: Our low-cost, high-impact anti-bias module provided learners with tools and practice, suggesting that such an effort is feasible, affordable, and effective. Our interdepartmental trainings have inspired our institution to develop approved statements clinicians may use when responding to race-based discrimination; offering a uniform approach to race-based microaggression or abuse can create a shared mental model for all team members, especially for those vulnerable to biased comments.