Patients as partners in radiology education: an innovative approach to teaching and assessing patient-centered communication.
OBJECTIVE
Effective communication is essential for high quality care, yet little is known about radiologists' communication with patients, what constitutes "best communication practices," and how best to teach and evaluate it. We piloted educational strategies and an assessment instrument to teach and evaluate radiologists' communication skills. We focused on communication in the diagnostic mammography suite, where patient-radiologist interactions are often intense and stressful.


METHODS
We adapted existing instruments to create a Radiology Communication Skills Assessment Tool (RCSAT). We piloted an educational program that included patients as teachers and raters of interpersonal and communication skills, and implemented a radiology objective structured clinical examination (OSCE). We measured radiology residents' self-assessed skills, confidence and stress, as well as patient-rated communication skills using the RCSAT.


RESULTS
Residents' baseline self-assessed communication skills regarding abnormal mammograms were fair, confidence in their communication was minimal, and they found this communication stressful. Overall baseline communication skills, rated by patient-teachers using the RCSAT, were 3.62 on a 5-point scale (1 = poor to 5 = excellent). Analysis of post-OSCE debriefing comments yielded nine themes regarding effective radiology communication, as well as residents' reflections on the communication challenges they experience. The themes were integrated into subsequent RCSAT revisions. Residents' reflections were used to inform teaching workshops.


CONCLUSIONS
Educational curricula on communication about difficult information can be implemented in radiology training programs. Radiology residents' performance can be assessed using a communication skills assessment tool during standardized patient-teacher encounters. Further research is necessary in this important domain.
Lown
Beth A
BA
Department of Medicine, Harvard Medical School, Mount Auburn Hospital, 300 Mount Auburn Street, Cambridge, MA 02138, USA. blown@mah.harvard.edu <blown@mah.harvard.edu>
Sasson
J Pierre
JP
Hinrichs
Peg
P
D003142:Communication; D003479:Curriculum; D004503:Education, Medical, Graduate / Q000379:methods*; D004521:Educational Measurement; D005260:Female; D017144:Focus Groups; D006801:Humans; D007396:Internship and Residency; D008297:Male; D010358:Patient Participation; D018802:Patient-Centered Care; D010817:Physician-Patient Relations; D010865:Pilot Projects; D011871:Radiology / Q000193:education*; D011795:Surveys and Questionnaires; D013663:Teaching / Q000379:methods*