title: Averting adverse events in communication skills training: a case series.
abstract: OBJECTIVE
  To document cases of adverse or near adverse events in communication skills training (CST) and to identify risk factors and strategies to reduce the likelihood of their occurrence.
  
  
  METHODS
  Six physician CST cases meeting criteria for an adverse or near adverse collected from experienced facilitators are analyzed and discussed.
  
  
  RESULTS
  Three types of adverse CST events are described: traumatic personal experiences or losses evoked by training; perception that feedback is not empathic; and where trainees are referred for remedial CST as a risk management strategy.
  
  
  CONCLUSIONS
  Early identification of risk factors and emotional cues of trainees is a key first step that facilitates implementation of remedial strategies to avert potential adverse events. Consideration of ways that physicians' personal experiences impact communication and good feedback techniques are vital. The implications of physicians sent to CST for risk management purposes is a new scenario that deserves special consideration.
  
  
  CONCLUSIONS
  To make CST safer and to optimize learning, early recognition of potential adverse events is essential. Specific feedback techniques should be mastered by all CST facilitators.
authors.affiliation: Memorial Sloan-Kettering Cancer Center, Department of Psychiatry and Behavioral Sciences, New York, NY 10022, USA. levint@mskcc.org
authors.forename: Tomer
authors.initials: T
authors.lastname: Levin
authors.forename: Jennifer
authors.initials: J
authors.lastname: Horner
authors.forename: Carma
authors.initials: C
authors.lastname: Bylund
authors.forename: David
authors.initials: D
authors.lastname: Kissane
mesh_terms: D003142:Communication; D004501:Education, Medical; D004645:Empathy; D005246:Feedback; D006801:Humans; D016544:Patient Simulation; D010817:Physician-Patient Relations; D012308:Risk Management; D013315:Stress, Psychological / Q000517:prevention & control*; D013337:Students, Medical / Q000523:psychology*; D014481:United States