Speak up: Radiology trainees benefit from communication skills training

Communication skills training proves effective for radiology trainees and is desired by many, according to an article published online March 28 in the Journal of the American College of Radiology.

As the face of healthcare changes, many expect radiologists to directly communicate with patients in order to form patient-centered practices and deliver value-based care. However, this growing expectation does not come without its challenges.

“Radiologists face considerable barriers to meeting these standards,” wrote lead author Stephen D. Brown, MD, of Boston Children’s Hospital, and colleagues. “Even veteran physicians experience substantial stress communicating with patients about unexpected or difficult diagnoses. These conversations all become more challenging for radiologists who have not previously met the patients with whom they must communicate. Without baseline relationships, many radiologists and patients have not had the opportunity to establish the trust key to navigating challenging conversations.”

Given the increasing emphasis on patient interaction, it is surprising that educational programs regarding communication are scarce for radiologists. Recently, however, training programs in the medical community have undergone a makeover. Many of these workshops now include didactic methods as well as simulation, role play, group discussion, and video presentations.

The article’s authors assessed the influence of communication skills training on radiology trainees’ comfort with communicating directly with patients and family members about unexpected or difficult diagnoses, radiologic errors, and radiation risks. They also investigated their attitudes about disclosing radiologic errors directly to patients and their families.

The workshops were comprised of twelve day-long communication skills sessions that were held over a period of two years. The workshop participants included 109 radiologists and fellows from 16 U.S. programs. Participants completed questionnaires before and after attending a full-day communication workshop. The workshops themselves were comprised of three modules focused on bad news, medical errors, and radiation risks, respectively.

The bad news module included participant discussion about previous difficult conversations they had experienced with patients, which was then followed by a video that catalyzed conversation about communicating bad news to patients. The second module, which focused on medical errors, provided discussion and lecture about best practice approaches to discussing errors. Coaching sessions and specific practical recommendations were then offered. Lastly, the radiation risks module gave a lecture about risks to participants and then offered enactments and discussions regarding radiologists’ roles in managing requests for radiologic procedures and other related topics.

All of the trainees complete the questionnaires, and their responses revealed comfort communicating with patients about bad news, errors, and radiation risks. Comfort increased from 44 percent to 73 percent, 25 percent to 44 percent, and 34 percent to 58 percent, respectively. After participation in the workshops, fewer trainees were unwilling to disclose medical errors despite medicolegal concerns, with a drop from 39 percent to 15 percent. After the training, 83 percent of participants wanted more communication training about error disclosure, 56 percent wanted more training about general communication, and 80 percent wanted additional training on talking about radiation risks.

“Our data suggest that this workshop is an effective approach to communication skills training related to bad news, radiologic error disclosure, and radiation risks,” wrote Brown and colleagues. “The significant gaps that persist in preparing radiologists for difficult conversations with patients and families represent a major challenge for radiology as it matures toward patient-focused care,” they concluded.