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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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Macy Initiative on Health Communication
Division of Primary Care
NYU School of Medicine
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