Radiology Trainees' Comfort With Difficult Conversations and Attitudes About Error Disclosure: Effect of a Communication Skills Workshop

被引:31
作者
Brown, Stephen D. [1 ,2 ,3 ]
Callahan, Michael J. [1 ]
Browning, David M. [4 ]
Lebowitz, Robert L.
Bell, Sigall K. [2 ,3 ,5 ]
Jang, Jisun [6 ]
Meyer, Elaine C. [1 ,7 ]
机构
[1] Childrens Hosp, Dept Radiol, Boston, MA 02115 USA
[2] Harvard Univ, Sch Med, Boston, MA USA
[3] Childrens Hosp, Inst Professionalism & Eth Practice, Boston, MA 02115 USA
[4] Massachusetts Gen Hosp, Dept Social Work, Boston, MA 02114 USA
[5] Beth Israel Deaconess Med Ctr, Dept Med, Boston, MA 02215 USA
[6] Childrens Hosp, Clin Res Ctr, Boston, MA 02115 USA
[7] Harvard Univ, Sch Med, Dept Psychiat, Boston, MA 02115 USA
关键词
Communication; professionalism; diagnostic errors; education; radiology; IMPROVING COMMUNICATION; CHALLENGES; RADIATION;
D O I
10.1016/j.jacr.2014.01.018
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
100231 [临床病理学]; 100902 [航空航天医学];
摘要
Purpose: The aim of this study was to assess the effect of communication skills training on radiology trainees' (1) comfort with communicating directly with patients and family members about unexpected or difficult diagnoses ("bad news"), radiologic errors, and radiation risks and (2) attitudes about disclosing radiologic errors directly to patients and their families. Methods: One hundred nine radiology trainees from 16 US programs were asked to complete questionnaires immediately before and after attending an institutional review board exempted, full-day communication workshop. Questionnaires assessed (1) comfort communicating with patients and their families generally and about bad news, radiologic errors, and radiation risks specifically; (2) attitudes and behavioral intent regarding a hypothetical vignette involving a radiologic error; and (3) desire for additional communication training. Results: All trainees completed the questionnaires. After completing the workshop, more trainees reported comfort communicating with patients about bad news, errors, and radiation risks (pre vs post, 44% vs 73%, 25% vs 44%, and 34% vs 58%, respectively, P < .001 for all). More also agreed that the radiologist in the error vignette should discuss the error with the patient (pre vs post, 84% vs 95%; P = .002) and apologize (pre vs post, 78% vs 94%; P < .001). After participation, fewer trainees reported unwillingness to disclose the error despite medicolegal concerns (pre vs post, 39 vs 15%; P < .001). Despite high baseline comfort (92%) and low stress (14%) talking with patients in general, most respondents after participation desired additional communication training on error disclosure (83%), general communication (56%), and radiation risks (80%). Conclusions: This program provides effective communication training for radiology trainees. Many trainees desire more such programs.
引用
收藏
页码:781 / 787
页数:7
相关论文
共 41 条
[1]
Accreditation Council for Graduate Medical Education, 2013, ACGME PROGR REQ GRAD
[2]
Accreditation Council for Graduate Medical Education American Board of Radiology, 2013, DIAGN RAD MIL PROJ 2
[3]
Breaking Bad News in the Breast Imaging Setting [J].
Adler, Dorit D. ;
Riba, Michelle B. ;
Eggly, Susan .
ACADEMIC RADIOLOGY, 2009, 16 (02) :130-135
[4]
American College of Radiology, IM 3 0 RAD PAT FOC C
[5]
[Anonymous], RAD CAR ART PAT CTR
[6]
Interprofessional Communication Skills Training for Serious Illness: Evaluation of a Small-Group, Simulated Patient Intervention [J].
Bays, Alison M. ;
Engelberg, Ruth A. ;
Back, Anthony L. ;
Ford, Dee W. ;
Downey, Lois ;
Shannon, Sarah E. ;
Doorenbos, Ardith Z. ;
Edlund, Barbara ;
Christianson, Phyllis ;
Arnold, Richard W. ;
O'Connor, Kim ;
Kross, Erin K. ;
Reinke, Lynn F. ;
Feemster, Laura Cecere ;
Fryer-Edwards, Kelly ;
Alexander, Stewart C. ;
Tulsky, James A. ;
Curtis, J. Randall .
JOURNAL OF PALLIATIVE MEDICINE, 2014, 17 (02) :159-166
[7]
Berlin Leonard, 2013, Radiology, V268, P4, DOI 10.1148/radiol.13130193
[8]
Informing Patients About Risks and Benefits of Radiology Examinations Utilizing Ionizing Radiation: A Legal and Moral Dilemma [J].
Berlin, Leonard .
JOURNAL OF THE AMERICAN COLLEGE OF RADIOLOGY, 2011, 8 (11) :742-743
[9]
The Mea Culpa Conundrum [J].
Berlin, Leonard .
RADIOLOGY, 2009, 253 (02) :284-287
[10]
Communicating Results of All Outpatient Radiologic Examinations Directly to Patients: The Time Has Come [J].
Berlin, Leonard .
AMERICAN JOURNAL OF ROENTGENOLOGY, 2009, 192 (03) :571-573