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

摘要

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.