Communication Deficits Among Surgical Residents During Difficult Patient Family Conversations

Research output: Contribution to journalArticle

Abstract

Objectives: To qualitatively analyze videotaped data of surgical residents and fellows interacting with standardized patients to identify communication weaknesses. To correlate our qualitative data with their quantitative scores. Design: We used discourse analysis to identify negative communication patterns among 10 surgical residents and fellows who were tested on interpersonal competencies during an objective structured clinical examination in 2014. We then correlated our findings with the validated evaluation outcomes. Descriptive statistics were then used to quantify our findings. Setting: The setting was an objective structured clinical examination performed in 2014 using standardized patient surrogate family members. Participants: The participants were a mix of first and third year surgical residents and critical care fellows. Results: The item that most strongly differentiated the bottom 5 from the top 5 performers was not answering the patient appropriately. This was exhibited in 3 ways among the lowest performers in our study: (1) paternalism, (2) vagueness, and (3) dehumanization. Our statistical analyses showed that the overall number of negative communication behaviors correlated with negative staff scores (r = −0.653, p < 0.05). Dehumanization and paternalism were the 2 behaviors most strongly correlated with negative staff scores (r = 0.796 and 0.781 respectively, p < 0.01). Conclusions: We found the lowest performers responded inappropriately to the patient, which we further delineated into vagueness, paternalism, and dehumanization. We propose positive communication strategies be taught to residents to improve how they are perceived by patients.

Original languageEnglish (US)
Pages (from-to)158-164
Number of pages7
JournalJournal of Surgical Education
Volume76
Issue number1
DOIs
StatePublished - Jan 1 2019

Fingerprint

Dehumanization
paternalism
Paternalism
deficit
conversation
Communication
resident
communication
staff
communication behavior
communication pattern
examination
descriptive statistics
discourse analysis
family member
Critical Care
evaluation

Keywords

  • Difficult Conversations
  • Discourse Analysis
  • Interpersonal and Communication Skills
  • Negative Communication Patterns
  • Patient Care
  • Patient-Centeredness
  • Professionalism

PubMed: MeSH publication types

  • Journal Article

Cite this

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title = "Communication Deficits Among Surgical Residents During Difficult Patient Family Conversations",
abstract = "Objectives: To qualitatively analyze videotaped data of surgical residents and fellows interacting with standardized patients to identify communication weaknesses. To correlate our qualitative data with their quantitative scores. Design: We used discourse analysis to identify negative communication patterns among 10 surgical residents and fellows who were tested on interpersonal competencies during an objective structured clinical examination in 2014. We then correlated our findings with the validated evaluation outcomes. Descriptive statistics were then used to quantify our findings. Setting: The setting was an objective structured clinical examination performed in 2014 using standardized patient surrogate family members. Participants: The participants were a mix of first and third year surgical residents and critical care fellows. Results: The item that most strongly differentiated the bottom 5 from the top 5 performers was not answering the patient appropriately. This was exhibited in 3 ways among the lowest performers in our study: (1) paternalism, (2) vagueness, and (3) dehumanization. Our statistical analyses showed that the overall number of negative communication behaviors correlated with negative staff scores (r = −0.653, p < 0.05). Dehumanization and paternalism were the 2 behaviors most strongly correlated with negative staff scores (r = 0.796 and 0.781 respectively, p < 0.01). Conclusions: We found the lowest performers responded inappropriately to the patient, which we further delineated into vagueness, paternalism, and dehumanization. We propose positive communication strategies be taught to residents to improve how they are perceived by patients.",
keywords = "Difficult Conversations, Discourse Analysis, Interpersonal and Communication Skills, Negative Communication Patterns, Patient Care, Patient-Centeredness, Professionalism",
author = "Branson, {Carolina R} and James Houseworth and Chipman, {Jeffrey G}",
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AU - Houseworth, James

AU - Chipman, Jeffrey G

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N2 - Objectives: To qualitatively analyze videotaped data of surgical residents and fellows interacting with standardized patients to identify communication weaknesses. To correlate our qualitative data with their quantitative scores. Design: We used discourse analysis to identify negative communication patterns among 10 surgical residents and fellows who were tested on interpersonal competencies during an objective structured clinical examination in 2014. We then correlated our findings with the validated evaluation outcomes. Descriptive statistics were then used to quantify our findings. Setting: The setting was an objective structured clinical examination performed in 2014 using standardized patient surrogate family members. Participants: The participants were a mix of first and third year surgical residents and critical care fellows. Results: The item that most strongly differentiated the bottom 5 from the top 5 performers was not answering the patient appropriately. This was exhibited in 3 ways among the lowest performers in our study: (1) paternalism, (2) vagueness, and (3) dehumanization. Our statistical analyses showed that the overall number of negative communication behaviors correlated with negative staff scores (r = −0.653, p < 0.05). Dehumanization and paternalism were the 2 behaviors most strongly correlated with negative staff scores (r = 0.796 and 0.781 respectively, p < 0.01). Conclusions: We found the lowest performers responded inappropriately to the patient, which we further delineated into vagueness, paternalism, and dehumanization. We propose positive communication strategies be taught to residents to improve how they are perceived by patients.

AB - Objectives: To qualitatively analyze videotaped data of surgical residents and fellows interacting with standardized patients to identify communication weaknesses. To correlate our qualitative data with their quantitative scores. Design: We used discourse analysis to identify negative communication patterns among 10 surgical residents and fellows who were tested on interpersonal competencies during an objective structured clinical examination in 2014. We then correlated our findings with the validated evaluation outcomes. Descriptive statistics were then used to quantify our findings. Setting: The setting was an objective structured clinical examination performed in 2014 using standardized patient surrogate family members. Participants: The participants were a mix of first and third year surgical residents and critical care fellows. Results: The item that most strongly differentiated the bottom 5 from the top 5 performers was not answering the patient appropriately. This was exhibited in 3 ways among the lowest performers in our study: (1) paternalism, (2) vagueness, and (3) dehumanization. Our statistical analyses showed that the overall number of negative communication behaviors correlated with negative staff scores (r = −0.653, p < 0.05). Dehumanization and paternalism were the 2 behaviors most strongly correlated with negative staff scores (r = 0.796 and 0.781 respectively, p < 0.01). Conclusions: We found the lowest performers responded inappropriately to the patient, which we further delineated into vagueness, paternalism, and dehumanization. We propose positive communication strategies be taught to residents to improve how they are perceived by patients.

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