Teaching Advanced Communication Skills to Trainees Caring for the Critically Injured

  • Sangeeta LambaEmail author
  • Anastasia Kunac
  • Anne Mosenthal


Trauma or injury is a sudden, unexpected event that often impacts previously healthy individuals, resulting in disability or death. Families and patients need support as they cope with this life-altering event. Physical or psychological impairments post-trauma may not improve despite the best treatment. Patients and families need ongoing effective and empathetic communication. Current training in trauma care is centered on life-saving clinical skills, with little attention to development of the empathic communication skills that are needed in this area of medicine. We can attempt to bridge this gap by designing a curriculum addressing trainee’s communication skills in trauma.


Trauma Surgery Emergency medicine ABCDE communication mnemonic Communication curriculum 


  1. 1.
    Hunter, W. (1829). A lecture, introductory to a course on anatomy, delivered by Dr. William Hunter, October 1775. Lancet, 12, 769–773. Retrieved from Scholar
  2. 2.
    Gawande, A. (2012). Two hundred years of surgery. The New England Journal of Medicine, 366(18), 1716–1723. Scholar
  3. 3.
    Han, J. L., & Pappas, T. N. (2018). A review of empathy, its importance, and its teaching in surgical training. Journal of Surgical Education, 75(1), 88–94. Retrieved from Scholar
  4. 4.
    Chen, D., Lew, R., Hershman, W., & Orlander, J. (2007). A cross-sectional measurement of medical student empathy. Journal of General Internal Medicine, 22(10), 1434–1438. Scholar
  5. 5.
    Asha, S., Chinnappa, J., & Diwan, A. D. (2013). Review article: Burnout in emergency medicine physicians. Emergency Medicine Australiasia, 25(6), 491–495.CrossRefGoogle Scholar
  6. 6.
    Hojat, M., Vergare, M. J., Maxwell, K., et al. (2009). The devil is in the third year: A longitudinal study of erosion of empathy in medical school. Academic Medicine, 84, 1182–1191.CrossRefGoogle Scholar
  7. 7.
    Neumann, M., Edelhäuser, F., Tauschel, D., et al. (2011). Empathy decline and its reasons: A systematic review of studies with medical students and residents. Academic Medicine, 86, 996–1009.CrossRefGoogle Scholar
  8. 8.
    ACGME competencies. Introduction to competency based education. Facilitator’s guide.
  9. 9.
    West, C. P., & Shanafelt, T. D. (2007). The influence of personal and environmental factors on professionalism in medical education. BMC Medical Education, 7, 1–9.CrossRefGoogle Scholar
  10. 10.
    Lamba, S., Bryczkowski, S., Tyrie, L., Nagurka, R., & Mosenthal, A. C. (2016). Teaching OSCE to assess trauma resident skills on how to hold difficult conversations with family of critically-injured patients. MedEdPORTAL Publications, 12, 10398. Scholar
  11. 11.
    Chipman, J. G., Beilman, G. J., Schmitz, C. C., & Seatter, S. C. (2007). Development and pilot testing of an OSCE for difficult conversations in surgical intensive care. Journal of Surgical Education, 64(2), 79–87.CrossRefGoogle Scholar
  12. 12.
    Gettman, M. T., Karnes, R. J., Arnold, J. J., et al. (2008). Urology resident training with an unexpected patient death scenario: Experiential learning with high fidelity simulation. The Journal of Urology, 180(1), 283–288.CrossRefGoogle Scholar
  13. 13.
    Davis, D., & Lee, G. (2011). The use of standardized patients in the plastic surgery residency curriculum: Teaching core competencies with objective structured clinical examinations. Plastic & Reconstructive Surgery, 128(1), 291–298.CrossRefGoogle Scholar
  14. 14.
    Short, M. W., Jorgensen, J. E., Edwards, J. A., et al. (2009). Assessing intern core competencies with an objective structured clinical examination. Journal of Graduate Medical Education, 1(1), 30–36.CrossRefGoogle Scholar
  15. 15.
    Wehbe-Janek, H., Song, J., & Shabahang, M. (2011). An evaluation of the usefulness of the standardized patient methodology in the assessment of surgery residents’ communication skills. Journal of Surgical Education, 68(3), 172–177.CrossRefGoogle Scholar
  16. 16.
    Reiss, H., Kelley, J. M., & Bailey, R. W. (2012). Empathy training for resident physicians: A randomized controlled trial of a neuroscience-informed curriculum. Journal of General Internal Medicine, 27(10), 1280–1286.CrossRefGoogle Scholar
  17. 17.
    Wouda, J. C., & van de Wiel, H. B. (2012). The communication competency of medical students, residents and consultants. Patient Education and Counseling, 86, 57–62.CrossRefGoogle Scholar
  18. 18.
    Hojat, M., Gonnella, J. S., & Nasca, T. J. (2002). The Jefferson scale of physician empathy: Further psychometric data and differences by gender and specialty at item level. Academic Medicine, 77(10), S58–S60.CrossRefGoogle Scholar
  19. 19.
    Sprangers, M. (1989). Response-shift bias in program evaluation. Impact Assessment, 7(2–3), 153–166.CrossRefGoogle Scholar
  20. 20.
    Chandawarkar, R. Y., Ruscher, K. A., Krajewski, A., et al. (2011). Pretraining and posttraining assessment of residents’ performance in the fourth accreditation council for graduate medical education competency: Patient communication skills. Archives of Surgery, 146(8), 916–921.CrossRefGoogle Scholar
  21. 21.
    Hutul, O. A., Carpenter, R. O., Tarpley, J. L., & Lamis, K. D. (2006). Missed opportunities: A descriptive assessment of teaching and attitudes regarding communication skills in a surgical residency. Current Surgery, 63(6), 401–409.CrossRefGoogle Scholar
  22. 22.
    Orgel, E., McCarter, R., & Jacobs, S. (2010). A failing medical educational model: A self-assessment by physicians at all levels of training of ability and comfort to deliver bad news. Journal of Palliative Medicine, 13, 677–683.CrossRefGoogle Scholar
  23. 23.
    Jacques, A. P., Adkins, E. J., Knepel, S., et al. (2011). Educating the delivery of bad news in medicine: Preceptorship versus simulation. International Journal of Critical Illness and Injury Science, 1(2), 121–124.CrossRefGoogle Scholar
  24. 24.
    Lamba, S., Pound, A., Rella, J. G., et al. (2012). Emergency medicine resident education in palliative care: A needs assessment. Journal of Palliative Medicine, 15(5), 516–520.CrossRefGoogle Scholar
  25. 25.
    Jurkovich, G. J., Pierce, B., Pananen, L., & Rivara, F. P. (2000). Giving bad news: The family perspective. Journal of Trauma and Acute Care Surgery, 48, 865–873.CrossRefGoogle Scholar
  26. 26.
    Klaristenfeld, D. D., Harrington, D. T., & Miner, T. J. (2007). Teaching palliative care and end-of-life issues: A core curriculum for surgical residents. Annals of Surgical Oncology, 14, 1801–1806.CrossRefGoogle Scholar
  27. 27.
    Minor, S., Schroder, C., & Heyland, D. (2009). Using the intensive care unit to teach end-of-life skills to rotating junior residents. The American Journal of Surgery, 197(6), 814–819.CrossRefGoogle Scholar
  28. 28.
    Baile, W. F., Buckman, R., Lenzi, R., et al. (2000). SPIKES- a six step protocol for delivering bad news: Application to the patient with cancer. The Oncologist, 5, 302–311.CrossRefGoogle Scholar
  29. 29.
    Knops, K., & Lamba, S. (2010). Clinical application of ASCEND: A pathway to higher ground for communication. Journal of Palliative Medicine, 13(7), 825–830.CrossRefGoogle Scholar
  30. 30.
    Tyrie, L., Mosenthal, A., Bryczkowski, S., Laboy, C., & Lamba, S. (2015). Difficult conversations after resuscitation in trauma: Video education E-module. AAMC MedEdPORTAL Publications, 11, 10092. Retrieved from Scholar
  31. 31.
    Lamba, S., Bryczkowski, S., Tyrie, L., & Nagurka, R. (2016). Teaching surgery residents the skills to communicate difficult news to patient and family members: A literature review. Journal of Palliative Medicine, 19(1), 101–107.CrossRefGoogle Scholar
  32. 32.
    Lamba, S., Bryczowski, S., Tyrie, L., Weissman, D. E., & Mosenthal, A. C. (2016). Death disclosure and delivery of difficult news in trauma. Fast facts and concepts #305. Journal of Palliative Medicine, 19(5), 566–567.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Sangeeta Lamba
    • 1
    Email author
  • Anastasia Kunac
    • 2
  • Anne Mosenthal
    • 2
  1. 1.Department of Emergency MedicineRutgers New Jersey Medical SchoolNewarkUSA
  2. 2.Department of SurgeryRutgers New Jersey Medical SchoolNewarkUSA

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