title: Resident involvement in postoperative conversations: an underused opportunity.
abstract: BACKGROUND
  Because of established attending-patient and family relationships and time constraints, residents are often excluded from the immediate postoperative conversation with family. Interpersonal and communication skills are a core competency, and the postoperative conversation is an opportunity to develop these skills. Our objective is to assess attitudes, experience, and comfort regarding resident participation during postoperative conversations with families.
  
  
  METHODS
  Residents and attending surgeons in an academic surgery center were surveyed regarding resident involvement in the postoperative conversation with families. Paper surveys were administered anonymously. Nonparametric statistics compared responses.
  
  
  RESULTS
  There were 45 survey respondents (23 residents, 22 attendings). All residents rated postoperative conversations with families, as "important" or "very important". Residents reported being "comfortable" or "very comfortable" with postoperative conversations. However, on average, residents reported fewer than 10 postoperative conversation experiences per year. Feedback was received by <30% on postoperative communication skills, but 88% wanted feedback. Most attendings reported it is "important" or "very important" for residents to communicate well with families during postoperative conversations, but rated residents' performance as significantly lower than the residents' self-assessments (P < 0.001). Attendings on average were only "somewhat comfortable" or "moderately comfortable" with residents conducting postoperative conversations with families, and only 68% reported allowing residents to do so. When bad news was involved, only 27% allowed resident participation. Most attendings (86%) believed residents need more opportunities with postoperative conversations.
  
  
  CONCLUSIONS
  Although most residents reported being comfortable with postoperative conversations, these survey results indicate that they have few opportunities. Developing a workshop on communication skills focused on the postoperative conversations with families may be beneficial.
authors.affiliation: Department of Surgery, University of Iowa, Carver College of Medicine, Iowa City, Iowa.
authors.forename: Allison W
authors.initials: AW
authors.lastname: Lorenzen
authors.affiliation: Department of Surgery, University of Iowa, Carver College of Medicine, Iowa City, Iowa.
authors.forename: Scott K
authors.initials: SK
authors.lastname: Sherman
authors.affiliation: Department of Family Medicine, University of Iowa, Carver College of Medicine, Iowa City, Iowa.
authors.forename: Marcy
authors.initials: M
authors.lastname: Rosenbaum
authors.affiliation: Department of Surgery, University of Iowa, Carver College of Medicine, Iowa City, Iowa. Electronic address: muneera-kapadia@uiowa.edu.
authors.forename: Muneera R
authors.initials: MR
authors.lastname: Kapadia
mesh_terms: D002983:Clinical Competence; D058015:Health Communication; D006801:Humans; D007396:Internship and Residency / Q000706:statistics & numerical data*; D011184:Postoperative Period; D013043:Specialties, Surgical / Q000193:education* / Q000706:statistics & numerical data
keywords: Communication; Patient families; Postoperative conversation; Residents; Surgeons