Radiology trainees' comfort with difficult conversations and attitudes about error disclosure: effect of a communication skills workshop

Stephen D Brown; Michael J Callahan; David M Browning; Robert L Lebowitz; Sigall K Bell; Jisun Jang; Elaine C Meyer

doi:10.1016/j.jacr.2014.01.018

Radiology trainees' comfort with difficult conversations and attitudes about error disclosure: effect of a communication skills workshop

J Am Coll Radiol. 2014 Aug;11(8):781-7. doi: 10.1016/j.jacr.2014.01.018. Epub 2014 Mar 27.

Authors

Stephen D Brown¹, Michael J Callahan², David M Browning³, Robert L Lebowitz², Sigall K Bell⁴, Jisun Jang⁵, Elaine C Meyer⁶

Affiliations

¹ Department of Radiology, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts; Institute for Professionalism and Ethical Practice, Boston Children's Hospital, Boston, Massachusetts. Electronic address: stephen.brown@childrens.harvard.edu.
² Department of Radiology, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts.
³ Department of Social Work, Massachusetts General Hospital, Boston, Massachusetts.
⁴ Institute for Professionalism and Ethical Practice, Boston Children's Hospital, Boston, Massachusetts; Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts.
⁵ Clinical Research Center, Boston Children's Hospital, Boston, Massachusetts.
⁶ Department of Radiology, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts.

PMID: 24684902
DOI: 10.1016/j.jacr.2014.01.018

Abstract

Purpose: The aim of this study was to assess the effect of communication skills training on radiology trainees' (1) comfort with communicating directly with patients and family members about unexpected or difficult diagnoses ("bad news"), radiologic errors, and radiation risks and (2) attitudes about disclosing radiologic errors directly to patients and their families.

Methods: One hundred nine radiology trainees from 16 US programs were asked to complete questionnaires immediately before and after attending an institutional review board-exempted, full-day communication workshop. Questionnaires assessed (1) comfort communicating with patients and their families generally and about bad news, radiologic errors, and radiation risks specifically; (2) attitudes and behavioral intent regarding a hypothetical vignette involving a radiologic error; and (3) desire for additional communication training.

Results: All trainees completed the questionnaires. After completing the workshop, more trainees reported comfort communicating with patients about bad news, errors, and radiation risks (pre vs post, 44% vs 73%, 25% vs 44%, and 34% vs 58%, respectively, P < .001 for all). More also agreed that the radiologist in the error vignette should discuss the error with the patient (pre vs post, 84% vs 95%; P = .002) and apologize (pre vs post, 78% vs 94%; P < .001). After participation, fewer trainees reported unwillingness to disclose the error despite medicolegal concerns (pre vs post, 39 vs 15%; P < .001). Despite high baseline comfort (92%) and low stress (14%) talking with patients in general, most respondents after participation desired additional communication training on error disclosure (83%), general communication (56%), and radiation risks (80%).

Conclusions: This program provides effective communication training for radiology trainees. Many trainees desire more such programs.

Keywords: Communication; diagnostic errors; education; professionalism; radiology.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Attitude of Health Personnel*
Communication*
Curriculum
Diagnostic Errors*
Education, Medical, Graduate / methods*
Female
Humans
Internship and Residency
Male
Patient Simulation
Radiology / education*
Surveys and Questionnaires
Truth Disclosure*
United States