JMIR Publications

ABSTRACT

Background:

Residents require practice and feedback to meet ACGME mandates and patient expectations for effective communication after harmful errors. Current instructional approaches have limitations. The Video-based Communication Assessment (VCA) is a novel tool to simulate scenarios for practice and obtaining crowdsourced assessments and feedback on physician communication skills.

Objective:

To evaluate the efficacy of VCA practice and feedback for the development of resident error disclosure skills.

Methods:

Pre-post study in 2020 with residents in pathology, OB/GYN, and internal medicine at an academic medical center. Resident audio responses to VCA scenarios were rated by at least 8 crowdsourced laypeople. Ratings were aggregated to create overall assessment scores on a 5-point scale for each resident for baseline (time one) and post-feedback (time two). Residents completed a survey of demographic characteristics.

Results:

Forty-eight residents completed two cases at time one, received a feedback report at four weeks, and completed two more cases. Mean ratings of residents’ communication were higher at time two compared to time one (3.75 vs 3.53, P<.001). Residents who reported prior error disclosure experience performed better at time one compared to those without such experience (3.63 vs. 3.46, p < .05). No differences in communication ratings were detected by specialty or years in training. Residents’ communication was rated higher for angry cases than sad cases (3.69 vs. 3.58, p < .05).

Conclusions:

Residents at all training levels can potentially improve error disclosure skills with VCA practice and feedback. Error disclosure curricula should prepare residents to respond to a range of patient affects.