Communication Matters: a Survey Study of Communication Didactics in Obstetrics/Gynecology Residency

An exploratory study of obstetrics trainees' experiences of breaking bad news

INTRODUCTION

Breaking bad news is one of the hardest tasks performed by doctors. The news can significantly impact on the patient's life; however, the process also generates stress for the doctor. The aim of this study was to explore the lived experiences of breaking bad news for obstetrics trainees in Ireland.

METHODS

A qualitative study using interpretative phenomenological analysis (IPA) was performed to capture the experience of breaking bad news for the trainees. Semi-structured interviews were conducted with trainees over Zoom. The transcripts were analysed in line with the IPA framework with the assistance of NVivo software.

RESULTS

Seven trainees were interviewed, five at Basic Specialist Training (BST) level and two at Higher Specialist Training (HST) level. Four superordinate themes were identified from the analysis: "the reality of working in obstetrics," "the role of the doctor," "development of communication skills" and "the importance of the patient experience." The trainees described breaking bad news in a variety of clinical contexts. This task could be emotionally draining; however, only two trainees mentioned ways of coping with this. Their formal training was limited with the majority of learning occurring "on the job."

CONCLUSIONS

This study provides an insight into factors that influence trainees experiences of breaking bad news. The results complemented existing literature and raised questions about how to better support trainees through increased training and psychological support.

State of Communication Training During the Breast Imaging Fellowship Year

OBJECTIVE

The purpose of this study was to survey breast imaging fellowship programs nationally on the state of communication skills training during fellowship training.

METHODS

In this IRB-exempt study, fellowship program director members of the Society of Breast Imaging (SBI) were anonymously surveyed on current provision and types of communication skills training in their fellowship curricula.

RESULTS

A six-question survey was sent to all 95 SBI member fellowship program directors with a response rate of 56% (53/95). Although direct fellow patient-centered communication interactions are practiced across all respondent training programs, formal communication skills training was offered in a minority of programs with 32% (17/53) providing formal communication in the form of a didactic lecture and 17% (9/53) engaging fellows in a simulation communication skills workshop. Of the 53 programs, 12 (22%) reported no formal communication skills training of any kind, while a majority (44/53, 83%) of programs provide regular feedback based on observed fellow-patient communication interactions.

CONCLUSION

Despite nearly uniform practice of engaging breast imaging fellows in direct patient-centered interaction at the onset of the fellowship training year, the majority of fellowship programs do not provide any formal communication skills training curricula at any point during fellowship training. To equip future breast radiologists with the skills to provide value in an increasingly patient-centered field, dedicated formal communication curricula ought to be incorporated consistently into breast imaging fellowship training programs.

Best practices for teaching psychosomatic obstetrics and gynecology

Psychosomatic obstetrics and gynecology (POG) encompasses a wide variety of topics. While specialists in this field agree that it is important for practicing clinicians to be familiar with psychosomatic issues related to women's health, there is no consensus about the best practices for teaching and assessing this knowledge, or even which are the topics that should be included. By examining existing literature on educational methodology, this paper aims to suggest best practices that are proven useful in teaching issues related to POG. The paper considers learning objectives for what should be taught, recommendations as to best practices for curriculum delivery, and suggestions for how to assess learners' ability to meet the objectives. Establishing guidelines for teaching POG may be useful for learners at different levels and in various settings.