title: Human Emotion and Response in Surgery (HEARS): a simulation-based curriculum for communication skills, systems-based practice, and professionalism in surgical residency training.
abstract: BACKGROUND
  This study examines the development and implementation of a pilot human factors curriculum during a 2-year period. It is one component of a comprehensive 5-year human factors curriculum spanning core competencies of interpersonal and communication skills, systems-based practice, and professionalism and using low-and high-fidelity simulation techniques.
  
  
  METHODS
  Members of the Department of Surgery and the Center for Clinical Communication and Performance Outcomes jointly constructed a curriculum for PGY1 and PGY2 residents on topics ranging from challenging communication to time and stress management. Video demonstrations, triggers, and simulated scenarios involving acting patients were created by surgeons and medical educators. Pre- and postintervention measures were obtained for communication skills, perceived stress level, and teamwork. Communication skills were evaluated using a series of video vignettes. The validated Perceived Stress Scale and Teamwork and Patient Safety Attitudes survey were used. Residents' perceptions of the program were also measured.
  
  
  RESULTS
  Twenty-seven PGY1 residents and 15 PGY2 residents participated during 2 years. Analyses of video vignette tests indicated significant improvement in empathic communication for PGY1 (t = 3.62, p = 0.001) and PGY2 (t = 5.00, p = 0.004). There were no significant changes to teamwork attitudes. Perceived levels of stress became considerably higher. PGY1 residents reported trying 1 to 3 strategies taught in the time management session, with 60% to 75% reporting improvement post-training.
  
  
  CONCLUSIONS
  This unique and comprehensive human factors curriculum is shown to be effective in building communication competency for junior-level residents in the human and emotional aspects of surgical training and practice. Continued refinement and ongoing data acquisition and analyses are underway.
authors.affiliation: Department of Surgery, University of Massachusetts Medical School, Worcester, MA 01605, USA. anne.larkin@umassmemorial.org
authors.forename: Anne C
authors.initials: AC
authors.lastname: Larkin
authors.forename: Mitchell A
authors.initials: MA
authors.lastname: Cahan
authors.forename: Giles
authors.initials: G
authors.lastname: Whalen
authors.forename: David
authors.initials: D
authors.lastname: Hatem
authors.forename: Susan
authors.initials: S
authors.lastname: Starr
authors.forename: Heather-Lyn
authors.initials: HL
authors.lastname: Haley
authors.forename: Demetrius
authors.initials: D
authors.lastname: Litwin
authors.forename: Kate
authors.initials: K
authors.lastname: Sullivan
authors.forename: Mark
authors.initials: M
authors.lastname: Quirk
mesh_terms: D001291:Attitude of Health Personnel; D002983:Clinical Competence; D003142:Communication; D003479:Curriculum; D004521:Educational Measurement; D004644:Emotions / Q000502:physiology*; D005260:Female; D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D008297:Male; D016544:Patient Simulation; D015203:Reproducibility of Results; D012189:Retrospective Studies; D014481:United States