Surgical EducationLearning by (video) example: a randomized study of communication skills training for end-of-life and error disclosure family care conferences

- We tested an online intervention with general and orthopedic surgery residents.
- We used reliable instruments to measure end-of-life and error disclosure encounters.
- All residents improved from pre- to post-test on both encounters.
- Low scoring residents assigned to treatment outperformed controls on end-of-life.
- Online resources alone are insufficient.

BackgroundTeaching residents to lead end of life (EOL) and error disclosure (ED) conferences is important.MethodsWe developed and tested an intervention using videotapes of EOL and error disclosure encounters from previous Objective Structured Clinical Exams. Residents (n = 72) from general and orthopedic surgery programs at 2 sites were enrolled. Using a prospective, pre-post, block group design with stratified randomization, we hypothesized the treatment group would outperform the control on EOL and ED cases. We also hypothesized that online course usage would correlate positively with post-test scores.ResultsAll residents improved (pre-post). At the group level, treatment effects were insignificant, and post-test performance was unrelated to course usage. At the subgroup level for EOL, low performers assigned to treatment scored higher than controls at post-test; and within the treatment group, post graduate year 3 residents outperformed post graduate year ​1 residents.ConclusionsTo be effective, online curricula illustrating communication behaviors need face-to-face interaction, individual role play with feedback and discussion.