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A Novel Curriculum to Improve the Interdisciplinary Communication of Residents in Obstetrics and Anesthesiology
Abstract Number: T-01
Abstract Type: Original Research
The importance of effective communication in health care teams is well established, with links to outcomes ranging from patient safety to provider job satisfaction. Consistent with this, the ACGME expects residents to demonstrate competency working on health care teams and communicating with physicians and other health professionals, and proficiency in these areas will be assessed by the Next Accreditation System. However, the common practice of training residents in parallel, specialty-specific programs provides few educational opportunities for the cross-discipline interaction needed to establish the knowledge, skills, and perspectives that promote effective interdisciplinary collaboration.
To address this concern, our multidisciplinary team of obstetricians, anesthesiologists, and communication specialists developed a new curriculum that provides OB/GYN and Anesthesia residents with opportunities to develop their interdisciplinary knowledge, understanding, and communication skills.
Design: Building on Intergroup Contact Theory(1), which provides a model for diminishing intergroup barriers through structured collaborative task work, we scheduled monthly case-based learning discussions for mixed groups of 5 to 8 Anesthesia and OB/GYN residents. Each session was facilitated by attendings from both disciplines and by a communication specialist, all with the goal of promoting resident dialogue rather than providing direct instruction. In addition, an experienced RN attended each session to provide a nursing perspective.
Applying the Theory of Relational Coordination(2), the cases and discussion sessions were designed to improve residents’ communication and shared decision making by elevating their appreciation of labor and delivery care team members’ shared goals, independent areas of expertise, and interdependent responsibilities. Based on participant feedback and facilitator debriefings, we subsequently developed two standard case formats and several facilitation practices that effectively encourage session participants to interact, collaborate, and educate one another about their interdependent roles.
Feedback: Anonymous post-session questionnaires (N=97) were completed by 60 residents (33 Anesthesia, 27 OB/GYN) who participated in one or more of the initial 14 discussion sessions. Most of the responses indicated that the program was a valuable addition to the curriculum (88%), that it was “moderately” or “very” useful at expanding both the ability to collaborate across disciplines (90%) and medical knowledge (82%), and that the respondent would “probably” or “definitely” change their communication as a result of the program (85%).
Conclusions: This curriculum appears to successfully address a critical yet neglected requirement of graduate medical education. Further evaluation in other settings is warranted.
1. Allport GW. The Nature of Prejudice. Reading,MA:Addison-Wesley 1954
2. Gittell JH et al. Med Care 2000;38:807-19