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Effects of Practicing With and Obtaining Crowdsourced Feedback From the Video-Based Communication Assessment App on Resident Physicians' Adverse Event Communication Skills: Pre-post Trial
Authors
White, Andrew AKing, Ann M
D'Addario, Angelo E
Brigham, Karen Berg
Dintzis, Suzanne
Fay, Emily E
Gallagher, Thomas H
Mazor, Kathleen M
UMass Chan Affiliations
MedicineDocument Type
Journal ArticlePublication Date
2022-10-03Keywords
communication assessmentcrowdsourcing
digital learning
digital response
graduate medical education
medical education
medical error
medical error disclosure
patient-centered care
physician communication
resident
simulation studies
video communication
virtual communication
virtual education
virtual learning
Metadata
Show full item recordAbstract
Background: US residents require practice and feedback to meet Accreditation Council for Graduate Medical Education mandates and patient expectations for effective communication after harmful errors. Current instructional approaches rely heavily on lectures, rarely provide individualized feedback to residents about communication skills, and may not assure that residents acquire the skills desired by patients. The Video-based Communication Assessment (VCA) app is a novel tool for simulating communication scenarios for practice and obtaining crowdsourced assessments and feedback on physicians' communication skills. We previously established that crowdsourced laypeople can reliably assess residents' error disclosure skills with the VCA app. However, its efficacy for error disclosure training has not been tested. Objective: We aimed to evaluate the efficacy of using VCA practice and feedback as a stand-alone intervention for the development of residents' error disclosure skills. Methods: We conducted a pre-post study in 2020 with pathology, obstetrics and gynecology, and internal medicine residents at an academic medical center in the United States. At baseline, residents each completed 2 specialty-specific VCA cases depicting medical errors. Audio responses were rated by at least 8 crowdsourced laypeople using 6 items on a 5-point scale. At 4 weeks, residents received numerical and written feedback derived from layperson ratings and then completed 2 additional cases. Residents were randomly assigned cases at baseline and after feedback assessments to avoid ordinal effects. Ratings were aggregated to create overall assessment scores for each resident at baseline and after feedback. Residents completed a survey of demographic characteristics. We used a 2×3 split-plot ANOVA to test the effects of time (pre-post) and specialty on communication ratings. Results: In total, 48 residents completed 2 cases at time 1, received a feedback report at 4 weeks, and completed 2 more cases. The mean ratings of residents' communication were higher at time 2 versus time 1 (3.75 vs 3.53; P<.001). Residents with prior error disclosure experience performed better at time 1 compared to those without such experience (ratings: mean 3.63 vs mean 3.46; P=.02). No differences in communication ratings based on specialty or years in training were detected. Residents' communication was rated higher for angry cases versus sad cases (mean 3.69 vs mean 3.58; P=.01). Less than half of all residents (27/62, 44%) reported prior experience with disclosing medical harm to patients; experience differed significantly among specialties (P<.001) and was lowest for pathology (1/17, 6%). Conclusions: Residents at all training levels can potentially improve error disclosure skills with VCA practice and feedback. Error disclosure curricula should prepare residents for responding to various patient affects. Simulated error disclosure may particularly benefit trainees in diagnostic specialties, such as pathology, with infrequent real-life error disclosure practice opportunities. Future research should examine the effectiveness, feasibility, and acceptability of VCA within a longitudinal error disclosure curriculum.Source
White AA, King AM, D'Addario AE, Brigham KB, Dintzis S, Fay EE, Gallagher TH, Mazor KM. Effects of Practicing With and Obtaining Crowdsourced Feedback From the Video-Based Communication Assessment App on Resident Physicians' Adverse Event Communication Skills: Pre-post Trial. JMIR Med Educ. 2022 Oct 3;8(4):e40758. doi: 10.2196/40758. PMID: 36190751; PMCID: PMC9577713.DOI
10.2196/40758Permanent Link to this Item
http://hdl.handle.net/20.500.14038/53158PubMed ID
36190751Rights
©Andrew A White, Ann M King, Angelo E D’Addario, Karen Berg Brigham, Suzanne Dintzis, Emily E Fay, Thomas H Gallagher, Kathleen M Mazor. Originally published in JMIR Medical Education (https://mededu.jmir.org), 03.10.2022. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Medical Education, is properly cited. The complete bibliographic information, a link to the original publication on https://mededu.jmir.org/, as well as this copyright and license information must be included.; Attribution 4.0 InternationalDistribution License
http://creativecommons.org/licenses/by/4.0/ae974a485f413a2113503eed53cd6c53
10.2196/40758
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Except where otherwise noted, this item's license is described as ©Andrew A White, Ann M King, Angelo E D’Addario, Karen Berg Brigham, Suzanne Dintzis, Emily E Fay, Thomas H Gallagher,
Kathleen M Mazor. Originally published in JMIR Medical Education (https://mededu.jmir.org), 03.10.2022. This is an open-access
article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/),
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR
Medical Education, is properly cited. The complete bibliographic information, a link to the original publication on
https://mededu.jmir.org/, as well as this copyright and license information must be included.
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