Wednesday, 9 August 2017

Teaching Communication in the Emergency Medicine Setting

Effectively communicating is an integral part of every healthcare job. However, the need to effectively communicate is a bit more acute in the emergency room setting. ED professionals know that even a minor breakdown in communication could mean the difference between life and death. So is there a way to teach new doctors effective communication skills before they ever make it to the ED? Perhaps. A group of professionals who put together a proposal recently published by the Journal of Emergency Medical Services believes simulation is the way to go.

Future emergency medicine physicians already experience simulations that teach them basic medical procedures that they will be performing as a matter of routine. The idea is to use simulations to allow them to practice the techniques so that they eventually become rote. By the time they are ready for real-world application, they are not having to think through those procedures step-by-step. They can do them quite naturally.

The proposal for using simulation to teach effective communication skills is based on the same principle. The proposal authors address a number of different skills broken down into two categories: meta objectives and specific objectives. If future emergency medicine doctors can learn the skills in both categories through simulation and practice, they will be ahead of the game whether they end up as locums or permanent ED employees.

Breaking Down the Objectives

Meta objectives are defined by the proposal as those objectives that exist in every possible simulation. They are objectives that are generally accepted within the arena of emergency medicine regardless of the situation a doctor may face in any given case. The proposal mentions both advanced cardiac life support and CUS skills as examples. CUS (I am Concerned; I am Uncomfortable; this is a Safety issue) skills are those used to elevate a situation along the chain until it is properly resolved.

As for specific objectives, they are those objectives that are unique to the case at hand. They are unique in the sense that doctors have to address each of them in light of a case's circumstances. The proposal lists six of them:

  • Introducing healthcare teams to patients
  • Explaining procedures and treatments to patients and their families
  • Learning how to break bad news to families or friends
  • Learning to prepare a family for a negative outcome
  • Communicating between professionals who share responsibilities for a patient
  • Ongoing public health education.

How Simulation Can Help

Communication objectives among emergency medicine doctors are normally self-evident. The difficulty is the fact that ED doctors often have to make split-second decisions and then communicate those decisions and the effects thereof. More often than not, they do not have time to think through how they are going to explain things to other staff members, family members, and the patients themselves.

Simulation provides an environment in which doctors can learn how to effectively communicate even under stress and anxiety. It is an environment that allows future doctors to practice their communication skills without actually harming anyone. Such an environment allows them to make mistakes, and then correct those mistakes, before they ever face critical circumstances in a real emergency department.

For the record, simulations alone will never prepare the ED physician for everything he or she will experience in the real world. There are emergency medicine doctors that have been on the job for years and are still experiencing things for the first time. It is part of the package. The simulation can help teach new doctors fundamental communication skills to such a degree that they become reflexive.


Post a Comment