TY - JOUR
T1 - Improving surgical residents' communication in disclosing complications
T2 - A qualitative analysis of simulated physician and patient surrogate conversations
AU - Branson, Carolina Fernandez
AU - Chipman, Jeffrey G.
N1 - Publisher Copyright:
© 2017 Elsevier Inc.
PY - 2018/2
Y1 - 2018/2
N2 - Background: In this study, we explore surgical resident communication with simulated patient surrogates (SPs), in an Objective Structured Clinical Examination (OSCE). Methods: We use discourse analysis (DA), a qualitative approach to analyzing language, to evaluate our residents' interactions with simulated patient surrogates. After identifying problematic communication patterns, we apply communication theory to discuss our findings and provide suggestions for improvement. Results: Residents consistently use bluntness, defined as delivering the news abruptly and without adequate preface, and evasiveness, defined as avoiding giving the news, to deliver difficult information. In addition, some residents use neutral language when empathetic language is warranted; and some try to direct the response of SPs, who then become defensive. Residents use evasiveness most frequently, followed by bluntness. These delivery methods often result in poor communication. Conclusions: We recommend further research in barriers to effective resident communication with patients, as well as future research on the positive effects of good communication on patient perception. Learning these skills will help residents to convey support and empathy to patients, thereby enhancing care.
AB - Background: In this study, we explore surgical resident communication with simulated patient surrogates (SPs), in an Objective Structured Clinical Examination (OSCE). Methods: We use discourse analysis (DA), a qualitative approach to analyzing language, to evaluate our residents' interactions with simulated patient surrogates. After identifying problematic communication patterns, we apply communication theory to discuss our findings and provide suggestions for improvement. Results: Residents consistently use bluntness, defined as delivering the news abruptly and without adequate preface, and evasiveness, defined as avoiding giving the news, to deliver difficult information. In addition, some residents use neutral language when empathetic language is warranted; and some try to direct the response of SPs, who then become defensive. Residents use evasiveness most frequently, followed by bluntness. These delivery methods often result in poor communication. Conclusions: We recommend further research in barriers to effective resident communication with patients, as well as future research on the positive effects of good communication on patient perception. Learning these skills will help residents to convey support and empathy to patients, thereby enhancing care.
KW - Communication
KW - Disclosure
KW - Language
KW - Qualitative
UR - http://www.scopus.com/inward/record.url?scp=85033557145&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85033557145&partnerID=8YFLogxK
U2 - 10.1016/j.amjsurg.2017.10.041
DO - 10.1016/j.amjsurg.2017.10.041
M3 - Article
C2 - 29137720
AN - SCOPUS:85033557145
SN - 0002-9610
VL - 215
SP - 331
EP - 335
JO - American journal of surgery
JF - American journal of surgery
IS - 2
ER -