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Abstract

Purpose: Communicating challenging news to patients is a core skill for all physicians, yet internal medicine residents have variable preparation and comfort level in this area. Lack of well-trained faculty and faculty time pressures limit resident education in communication skills. The use of near peer teachers can be used to expand the capacity of instructors for this vital skill-set. Method: Internal medicine residents participated in a communication skills workshop (Workshop A) based on the SPIKES framework facilitated by palliative-care faculty. In a follow-up session (Workshop B), eight months later, 3rd year residents acted as near peer teachers for 1st year residents. Results: Residents (Workshop A: N=82, Workshop B: N=87) completed surveys before and after each workshop. There was a significant increase in self-reported comfort, with 45.6% (52/114) of residents feeling moderately or very comfortable pre- vs. 77.2% (88/114) post-workshop (pnd and 3rd year residents felt more confident communicating challenging news after either observing or teaching workshop B. Conclusions: Following an initial workshop centered on the SPIKES framework, residents felt more confident in communicating challenging news, and were subsequently able to use these tools as near peer teachers for new 1st year residents. Using residents as near peer teachers can provide a sustainable means of integrating core communication skills into residency curricula.

Author Bio(s)

Rebecca Shafer, MD, is a General Internal Medicine and Obesity Fellow in the Department of General Internal Medicine at the Zucker School of Medicine at Hofstra/Northwell.

Gabrielle Goldberg, MD, is an Assistant Professor in the Department of Science Education at the Zucker School of Medicine at Hofstra/Northwell.

Stephanie Izard, MPH, is an Assistant Biostatistician in the Center for Health Innovations and Outcomes Research at the Feinstein Institute for Medical Research.

Sindee Weiss, MD, is an Assistant Professor in the Department of Palliative Medicine at the Zucker School of Medicine at Hofstra/Northwell.

Lauren Block, MD, MPH, is an Associate Professor in the Department of Medicine at the Zucker School of Medicine at Hofstra/Northwell.

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