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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
Students will become familiar with basic principles of educating patients about surgical procedures and post-op care.

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

Videotaped Interviews (Surgeon with Standardized Patients)
Role-Play Cases (Colectomy and Laparoscopic Choleycystectomy)
Handout-Card on Ask, Tell Ask.

Gordon GH, Duffy FD. Educating and Enlisting Patients. JCOM 5 (4):45-50, 1998.

Seminar #2- Obtaining Informed Consent/Shared Decision Making

Students will be able to conduct an effective and efficient informed consent discussion.

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
· 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.

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

Students will know the basic elements of delivering adverse information to patients.

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.

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).

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
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