title: Radiology trainees' comfort with difficult conversations and attitudes about error disclosure: effect of a communication skills workshop.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Radiology, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts; Institute for Professionalism and Ethical Practice, Boston Children's Hospital, Boston, Massachusetts. Electronic address: stephen.brown@childrens.harvard.edu.
authors.forename: Stephen D
authors.initials: SD
authors.lastname: Brown
authors.affiliation: Department of Radiology, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Callahan
authors.affiliation: Department of Social Work, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: David M
authors.initials: DM
authors.lastname: Browning
authors.affiliation: Department of Radiology, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts.
authors.forename: Robert L
authors.initials: RL
authors.lastname: Lebowitz
authors.affiliation: Institute for Professionalism and Ethical Practice, Boston Children's Hospital, Boston, Massachusetts; Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts.
authors.forename: Sigall K
authors.initials: SK
authors.lastname: Bell
authors.affiliation: Clinical Research Center, Boston Children's Hospital, Boston, Massachusetts.
authors.forename: Jisun
authors.initials: J
authors.lastname: Jang
authors.affiliation: Department of Radiology, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts.
authors.forename: Elaine C
authors.initials: EC
authors.lastname: Meyer
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003142:Communication; D003479:Curriculum; D003951:Diagnostic Errors; D004503:Education, Medical, Graduate / Q000379:methods*; D005260:Female; D006801:Humans; D007396:Internship and Residency; D008297:Male; D016544:Patient Simulation; D011871:Radiology / Q000193:education*; D011795:Surveys and Questionnaires; D014342:Truth Disclosure; D014481:United States
keywords: Communication; diagnostic errors; education; professionalism; radiology