MedEdPORTAL (Feb 2016)
Simulation-Based Empathetic Communication Curriculum
Abstract
Abstract Introduction This is a 1.5-hour empathy curriculum designed for four to five resident participants at a time and includes a simulation scenario followed by a debriefing session, a didactic session, and a role-playing exercise. The residents are the patient in a simulated scenario where they experience preparations to undergo an urgent cesarean delivery. Methods The simulation experience includes being rushed to the operating room (OR) by an obstetrician and anesthesiologist, the consent process, undergoing a medical history and physical exam, responding to questions and commands imposed by the health care team, hemodynamic monitor application, preparatory OR work, and witnessing emergency team dynamics. The 30-minute debriefing session covers topics such as residents' experience of an urgent cesarean and how it may differ from their patients' perspective, the health care providers' team dynamics in emergency situations, residents' experiences as providers, and their role models and personal and systemic barriers to empathetic communication with their patients. The didactic session contains the peer-reviewed literature linking empathy with health outcomes and perceptions of care and triggers discussion for whether empathy can be taught. Results Sixty anesthesiology residents underwent the empathy simulation curriculum. They gave the curriculum very high marks on the evaluations (65% response rate). The residents felt the curriculum was time well spent and the experience was realistic and “eye-opening.” They enjoyed having an opportunity to discuss empathy in doctoring since most of them do not have any communication skills learning following the first 2 years in medical school. The Jefferson Scale of Physician Empathy scores were higher after the empathy curriculum'baseline mean 103 (IQR 97–111) and postcurriculum mean 110 (IQR 102–118)'with a difference of 7 (CI 4, 8; p < .001). Discussion This is a one-time intervention that does an excellent job increasing participant awareness of their patients' experience. Most interventions need follow-up as learning decays through time. The concepts learned here need reinforcement in the clinical setting. Ideally, other clinicians in the department need to value and encourage empathetic behaviors and not undermine the curriculum's objectives. Unfortunately, the participants frequently mentioned in the didactic discussion the lack of clinical reinforcement of these concepts. In the future, it would be useful to create a follow-up curriculum using acting exercises to aid in empathy and more practice for mastery of the empathetic communication techniques.
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