Communication Programs, Communication Research
Conditions
Keywords
Surgical Trainees, Fundamentals of Communication in Surgery, FCS, Best Case/Worst Case, BC/WC, Better Conversations
Brief summary
The goal of this observational study is to evaluate the impact of the FCS curriculum on achieving the learning objectives and resident reported self-efficacy with communication skills and determine the scalability of the training across a range of general surgery training programs
Detailed description
The researchers have developed a 5-year curriculum for surgical trainees called the Fundamentals of Communication in Surgery (FCS). The training includes core communication skills, e.g., expressing empathy, and frameworks to support informed consent and serious illness conversations, specifically Best Case/Worst Case and Better Conversations. The curriculum provides one developmentally appropriate two-hour session for each of the five years of surgical training. Because the training is skills based (e.g., scenario planning) and not procedure based (e.g., goals of care conversations) exercises are focused on specific techniques that build over subsequent sessions. Researchers will invite 1-3 surgical attendings per site with an interest in surgical education to serve as trainers for the FCS curriculum. All general surgery trainees at each institution will have access to the training program as part of their regularly scheduled educational curriculum, regardless of training year or status as a categorical resident. If there is interest, researchers will provide access to the curriculum to fellows and residents in affiliated programs, e.g., plastic surgery. Researchers will invite site personnel who have roles related to surgical education including the program director and associate program director (if applicable), 2 to 3 attending surgeons who have high contact with residents in urgent care settings (e.g., emergency general surgery), 1 to 2 members of the education coordination team.
Interventions
BEHAVIORALDelivery of FCS Skills Curriculum
The UW study team will conduct two 2-hour train-the-trainer sessions with all surgical attendings who have committed to participation as a trainer in the FCS curriculum. The designated trainer will deliver each 2-hour session during the existing formal educational time for residents. If existing protected educational time will not allow for a 2-hour training session, the sessions can be delivered in two 1-hour sessions. These sessions will be incorporated into the curriculum similar to all other formal training provided to residents with the same expectations to attend. Each 2-hour FCS session starts with a 30-minute exercise in empathic communication. The remaining 90 minutes are devoted to skills that support decision making about surgery.
Sponsors
University of Wisconsin, Madison
Josiah Macy, Jr. Foundation
University of Oklahoma
University of Pittsburgh
University of South Florida
West Virginia University
Duke University
Association for Academic Surgery
Inova Fairfax Medical Campus
Study design
Observational model
CASE_ONLY
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* surgical attendings with an interest in surgical education * surgery trainees
Exclusion criteria
* none
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Trainee Reaction to the Training | Day of training through 2 months post-training | Surgical trainees will complete a 5-item survey on a scale of 1-5 (1= strongly disagree, 5= strongly agree). Total scores range from 5-25, with higher scores indicating greater acceptability of the curriculum. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Trainee Self-Efficacy - Ability | Before training, directly after training, and 2 months post-training | Surgical trainees will complete an 8-item ability survey on a scale of 1-5 (1= not at all able to do, 5= easily able to do). Total scores range from 8-40, with higher scores indicating a better ability to communicate. |
| Receipt of Curriculum | 1 day of training | Educational coordinators will provide a direct count of the number of categorical residents who attend their session, divided by the total number eligible to attend. |
| Performance of Skills | Baseline (before training), directly after training, and 2 months post-training | Trainers will observe surgical trainees to evaluate them on various items using a scoring rubric. Each item will be scored as not done, done, or exceptional. Binary Scoring (0/1) 0: Not Done 1: Done Ternary Scoring (0/1/2) 0: Not Done 1. Done 2. Exceptional |
| Fidelity to the Intervention | 1 day of training | A member of the UW study team will travel to each institution once to observe one 2-hour educational session in person. The observer will use an implementation checklist (rubric) to record performance of discrete elements of the curriculum and the fidelity to the overall training program goals as described in the learning objectives. |
| Trainee Self-Efficacy - Preparedness | Before training, directly after training, and 2 months post-training | Surgical trainees will also complete a 6-item preparedness survey with a scale of 1-5 (1= not at all prepared, 5= very well prepared). Total scores range from 6-35, with higher scores indicating greater confidence in navigating treatment decisions. |
Countries
United States
Contacts
PRINCIPAL_INVESTIGATORMargaret (Gretchen) L Schwarze, MD, MPP
University of Wisconsin, Madison
Outcome results
None listed