Surgery
Students experience
three 1 ½ hour seminars addressing Communication Skills particularly
relevant to Surgeons. Each seminar has a brief lecture/discussion followed
by a videotape review of a member of the surgery department. After discussing
the tape students then practice skills and receive feedback.
Seminar #1- Patient Education
Goal:
Students will become familiar with basic principles of educating patients
about surgical procedures and post-op care.
Objectives:
By the end of the session students will:
· Be able to list the variety of ways that surgeons educate patients:
preparing a patient for surgery, discussing post-op care, engaging in
informed decision making (including informed consent), delivering a diagnosis
and/or discussing an outcome.
· Describe the process of effective education (assessing needs,
delivering clear and concise information and assessing understanding).
· Analyze an example of a patient education session using a checklist.
· Practice using the recommended skills (see checklist) and receive
feedback.
· Appreciate the importance of effective patient education as a
crucial part of patient care
Resources:
Videotaped Interviews (Surgeon with Standardized Patients)
Role-Play Cases (Colectomy and Laparoscopic Choleycystectomy)
Handout-Card on Ask, Tell Ask.
References:
Gordon GH, Duffy FD. Educating and Enlisting Patients. JCOM 5 (4):45-50,
1998.
Seminar #2- Obtaining Informed
Consent/Shared Decision Making
Goal:
Students will be able to conduct an effective and efficient informed consent
discussion.
Objectives:
By the end of the session students will:
· Define both the legal and ethical components of informed consent.
· Know how to obtain information regarding the indications/risks/benefits/alternatives
of the
procedure.
· Describe the elements of shared decision making.
· Analyze an informed consent discussion using a checklist.
· Practice the recommended skills in a role-play and receive feedback.
· Accept and accommodate each individuals desired role in the decision
making process.
· Appreciate the positive outcomes of the informed decision making
process.
Resources:
Videotaped Interviews (Surgeon with Standardized Patients)
Role-Play Cases (Carotid Endarterectomy and Hernioraphy)
Braddock CH, Edwards KA, Hasenberg NM, Laidley TL, Levinson W. Informed
decision
making in outpatient practice: time to get back to basics. JAMA 282(24):2313-20,
1999
Dec 22-29.
Faculty (see Appendix 13 for example of faculty notes)
Seminar #3- Delivering Adverse
Information
Goal:
Students will know the basic elements of delivering adverse information
to patients.
Objectives:
By the end of the session the students will:
· Know what is adverse information depends on the individual.
· Understand how to prepare oneself to give adverse information
(attend to one's emotions, face-face when possible, private, sufficient
time, have all necessary information, discuss possible outcomes with patient
prior to testing, include significant other).
· Assess a physician demonstrating delivering adverse information
using a checklist.
· Practice delivering adverse information and receiving feedback
according to a checklist.
· Appreciate the importance of delivering adverse information effectively.
Resources:
Videotaped Interviews (Surgeon with Standardized Patients)
Practice Case with Standardized Patient (Delivering Adverse Information
after the results of a
breast biopsy and lymph node resection).
References:
1. Fallowfield LJ, Lipkin M. Delivering Sad or Bad News. In Lipkin M,
Putnam SM, Lazare A,
eds. The Medical Interview Clinical Care, Education and Research. NY:
Springer-Verlag, 1995:324-330.
2. Buckman R, Baile W. How to Break Bad News to Patients With Cancer:A
Practical Protocol
for Clinicians. American Society of Clinical Oncology Educational Book,
Alexandria, VA, 1998, pages 203-208.
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