Journal Article

The surgical resident experience in serious illness communication: A qualitative needs assessment with proposed solutions

Im, Cecilia J., Kirkwood, Kimberly S., Cook, Allyson C., Lin, Joseph A., O'Sullivan, Patricia

2021

Overview

Serious illness communication skills are important tools for surgeons, but training in residency is limited. Thirteen senior surgical residents at an academic center were interviewed about their experiences with serious illness communication. Conventional content analysis was performed using established communication frameworks and inductive development of themes. Residents had frequent conversations and employed known communication strategies. Three themes highlighted challenges they face. Illness severity included factors attributed to the illness that made serious illness communication more challenging: symptoms, poor prognosis, and urgency. Knowledge and feelings included the factual understanding and emotional experience of residents, patients, and families. Academic structure included hierarchy and the residents’ dual role as learners and teachers. On reflection, residents identified needing greater experiential practice, analogous to learning procedural skills. Surgical residents regularly face serious illness conversations with little training beyond observation of role models. Dedicated training may help meet this need. •Surgical residents face serious illness communication frequently.•Challenges arise from illness severity, knowledge and feelings, and hierarchy.•Residents receive little training besides observation of role models.•Residents find communication skills akin to procedural skills and can teach others.

• Publisher: Elsevier Inc,Elsevier Limited
• Subject: Breaking bad news / Clinical Competence - standards / Communication / Communication skills / Content analysis / Critical care / Curricula / Families & family life / Female / General Surgery - education / Humans / Illnesses / Internship and Residency / Interviews / Interviews as Topic / Male / Medical residencies / Medical students / Medicine / Needs analysis / Needs Assessment / Oncology / Palliative care / Pathophysiology / Patient satisfaction / Physician-Patient Relations / Qualitative research / Resident education / Serious illness communication / Shared decision making / Training / Trauma / Truth Disclosure / Vascular surgery / Verbal communication