Training to Promote Empathic Communication in Graduate Medical Education: A Shared Learning Intervention in Internal Medicine and General Surgery

Bethany J Lockwood; Jillian Gustin; Nicole Verbeck; Kara Rossfeld; Kavitha Norton; Todd Barrett; Richard Potts; Robert Towner-Larsen; Brittany Waterman; Steven Radwany; Christopher Hritz; Sharla Wells-Di Gregorio; Scott Holliday

doi:10.1089/pmr.2021.0036

Training to Promote Empathic Communication in Graduate Medical Education: A Shared Learning Intervention in Internal Medicine and General Surgery

Palliat Med Rep. 2022 Mar 30;3(1):26-35. doi: 10.1089/pmr.2021.0036. eCollection 2022.

Affiliations

¹ Division of Palliative Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
² Office of Curriculum and Scholarship, The Ohio State University College of Medicine, Columbus, Ohio, USA.
³ Complex General Surgical Oncology, Ohio Health, Columbus, Ohio, USA.
⁴ Patient Experience, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
⁵ Medical Staff Administration, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
⁶ College Administration, The Ohio State University College of Medicine, Columbus, Ohio, USA.
⁷ Division of General Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.

Abstract

Background: Empathic communication skills have a growing presence in graduate medical education to empower trainees in serious illness communication.

Objective: Evaluate the impact, feasibility, and acceptability of a shared communication training intervention for residents of different specialties.

Design: A randomized controlled study of standard education v. our empathic communication skills-building intervention: VitalTalk-powered workshop and formative bedside feedback using a validated observable behavioral checklist.

Setting/subjects: During the 2018-2019 academic year, our intervention was implemented at a large single-academic medical center in the United States involving 149 internal medicine and general surgery residents.

Measurements: Impact outcomes included observable communication skills measured in standardized patient encounters (SPEs), and self-reported communication confidence and burnout collected by surveys. Analyses included descriptive and inferential statistics, including independent and paired t tests and multiple regression model to predict post-SPE performance.

Results: Of residents randomized to the intervention, 96% (n = 71/74) completed the VitalTalk-powered workshop and 42% (n = 30/71) of those residents completed the formative bedside feedback. The intervention demonstrated a 33% increase of observable behaviors (p < 0.001) with improvement in all eight skill categories, compared with the control who only showed improvement in five. Intervention residents demonstrated improved confidence in performing all elicited communication skills such as express empathy, elicit values, and manage uncertainty (p < 0.001).

Conclusions: Our educational intervention increased residents' confidence and use of essential communication skills. Facilitating a VitalTalk-powered workshop for medical and surgical specialties was feasible and offered a shared learning experience for trainees to benefit from expert palliative care learning outside their field.

Keywords: communication training; empathy; graduate medical education; shared learning.