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Communication Skills Training for Internal Medicine Residents Using a Brief Animated Video

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Abstract

Patient communication courses are time-intensive, making incorporation into residency curricula challenging. Using a short video could be an efficient means to teach residents communication skills. We created a 4-min animated video focused on the “ask more and summarize technique”. Residents rotating on the inpatient oncology and palliative care service received a video link with a survey (S1) on the tool and its projected utility. A second survey (S2) was sent upon rotation completion to assess the utility of the technique. A 6-month follow up e-mail was sent to determine retention of skills. A total of 52/106 residents responded to S1 and 32/52 to S2. Median age was 28 years and 86% were PGY-1. On S1, 95% enjoyed the format, and 95% thought the narration was an effective learning tool and 90% that the animation was effective. A majority (87%) felt the tool would be useful. On comparing self-reported acquisition of skills for paired survey responses, there was a significant increase in asking more regarding patient questions (p = 0.04) but not summarizing back responses (p = 0.1). This tool was reported to be useful in a variety of settings including explaining prognoses, unrealistic patient expectations, upset patients, and patients with fear or anxiety. A 6-month follow up survey (n = 22) showed that almost all the respondents continued to report using the skills learned. A short video is a brief and effective tool that can be incorporated into a busy clinical curriculum to teach residents communication skills in the areas of cancer and palliative care.

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Author information

Author notes

  1. Rushad Patell and Geeda Maddaleni contributed equally to this work.

Authors and Affiliations

  1. Division of Hematology and Hematologic Malignancies, Beth Israel Deaconess Medical Center (East Campus), Shapiro Clinical Center 9th Floor, 330 Brookline Avenue, Boston, MA, 02215-5400, USA

    Rushad Patell & Jason Freed

  2. Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA

    Geeda Maddaleni

  3. Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, USA

    Laura Dodge

  4. Section of Palliative Care, Division of General Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA

    Mary Buss

Authors
  1. Rushad Patell
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  2. Geeda Maddaleni
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  3. Laura Dodge
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  4. Mary Buss
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  5. Jason Freed
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Corresponding author

Correspondence to Jason Freed.

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Appendices

Appendix 1. Animated video tool

https://www.youtube.com/watch?v=udvSYZ1trKQ&t=5s

Appendix 2. Survey 1

  1. 1.

    Before doing the module, how often were finding out more information about questions patients were asking?

    • Never

    • Almost Never (~ 1–2 a month)

    • Rarely (~ 1–2 times a week)

    • Often (1–2 times a day)

    • Very Often (3–5 times a day)

    • Extremely often (5–10 times a day)

    • Always (almost every patient encounter, every day)

  2. 2.

    Before doing the module, how often were you summarizing back to patient’s what you heard them say?

    • Never

    • Almost Never (~ 1–2 a month)

    • Rarely (~ 1–2 times a week)

    • Often (1–2 times a day)

    • Very Often (3–5 times a day)

    • Extremely often (5–10 times a day)

    • Always (almost every patient encounter, every day)

  3. 3.

    After watching the module, how useful do you feel the information provided will be during the rest of your training?

    • Not at all useful

    • Of little Use

    • Useful

    • Somewhat Useful

    • Very Useful

  4. 4.

    On your oncology/palliative rotation, how often do you think you will use the skills taught in today’s module?

    • Never

    • Almost Never (~ 1–2 a month)

    • Rarely (~ 1–2 times a week)

    • Often (1–2 times a day)

    • Very Often (3–5 times a day)

    • Extremely often (5–10 times a day)

    • Always (almost every patient encounter, every day)

  5. 5.

    If you could make one major change to the module what would it be?

  6. 6.

    Age

  7. 7.

    Gender

    • Male

    • Female

    • Other

  8. 8.

    Stage of Training

    • Medical Student

    • PGY 1

    • PGY 2

    • PGY 3

    • PGY 4

  9. 9.

    Have you attended any formal communication training so far during residency?

    • Yes

    • No

Appendix 3. Survey 2

  1. 1.

    During the oncology rotation how often did you find out more information about patient’s questions?

    • Never

    • Almost Never (~ 1–2 a month)

    • Rarely (~ 1–2 times a week)

    • Often (1–2 times a day)

    • Very Often (3–5 times a day)

    • Extremely often (5–10 times a day)

    • Always (almost every patient encounter, every day)

  2. 2.

    During the oncology rotation how often did you find out more and summarize back to patient’s what you heard them say?

    • Never

    • Almost Never (~ 1–2 times over 4 weeks)

    • Rarely (~ 1–2 times a week)

    • Often (1–2 times a day)

    • Very Often (3–5 times a day)

    • Extremely often (5–10 times a day)

    • Always (almost every patient encounter, every day)

  3. 3.

    On the rotation, under what circumstances did you find yourself using the “Ask More & Summarize” technique? (choose all that apply)

    • Explaining prognosis to patient

    • Unrealistic patient expectations

    • Angry/Upset patients or their families

    • Patients with fear and/or anxiety

    • Other (please specify in space below)

    • Please list ‘other’ circumstances you found technique useful.

  4. 4.

    On the rotation, was there a time(s) that you wish you would have used the “Ask More & Summarize” technique, but did not?

    • Yes

    • No

Please list reasons you could not use the technique:

  1. 5.

    What other communication skills did you find helpful during your oncology/palliative rotation? (choose all that apply)

    • Empathy

    • Agenda Setting

    • Conveying value + respect

    • Listening to the patient’s perspective

    • Teach Back

    • Other (please specify below)

Please specify other techniques/skills used

  1. 6.

    Age

  2. 7.

    Gender

    • Male

    • Female

    • Other

  3. 8.

    Stage of Training

    • Medical Student

    • PGY 1

    • PGY 2

    • PGY 3

    • PGY 4

Appendix 4. Survey 3

  1. 1.

    In the last 1 month, how often did you find out more information about patient’s questions before answering them?

    • Never

    • Almost Never (~ 1–2 a month)

    • Rarely (~ 1–2 times a week)

    • Often (1–2 times a day)

    • Very Often (3–5 times a day)

    • Extremely often (5–10 times a day)

    • Always (almost every patient encounter, every day)

  2. 2.

    In the last 1 month, how often did you summarize back to patients what you heard them say?

    • Never

    • Almost Never (~ 1–2 times over 4 weeks)

    • Rarely (~ 1–2 times a week)

    • Often (1–2 times a day)

    • Very Often (3–5 times a day)

    • Extremely often (5–10 times a day)

    • Always (almost every patient encounter, every day)

  3. 3.

    During which rotations did you use these above techniques? (Check all that apply)

    • Oncology

    • Palliative care

    • ICU

    • General medicine wards

    • Subspecialty wards (cardiology, liver, etc)

    • Primary care clinic

    • Subspecialty clinic

  4. 4.

    Under what circumstances did you find yourself using these techniques? (Check all that apply)

    • Explaining prognosis to patient

    • Unrealistic patient expectations

    • Angry/Upset patients or their families

    • Patients with fear and/or anxiety

    • Other (please specify in space below)

    • Please list ‘other’ circumstances you found technique useful.

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Patell, R., Maddaleni, G., Dodge, L. et al. Communication Skills Training for Internal Medicine Residents Using a Brief Animated Video. J Canc Educ 37, 379–386 (2022). https://doi.org/10.1007/s13187-020-01825-y

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  • DOI: https://doi.org/10.1007/s13187-020-01825-y

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