Abstract: SA-PO205
Teaching Communications Skills in Nephrology Utilizing Sociodrama
Session Information
- Educational Research
October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Educational Research
- 800 Educational Research
Authors
- Shah, Maulin, Baylor College of Medicine, Houston, Texas, United States
- Lorch, Robert, Baylor College of Medicine, Houston, Texas, United States
- Baile, Walter F., MD Anderson Cancer Center, Houston, Texas, United States
- Workeneh, Biruh, MD Anderson Cancer Center, Houston, Texas, United States
- Raghavan, Rajeev, Baylor College of Medicine, Houston, Texas, United States
Background
Although conversations between patients and nephrologists regarding chronic kidney disease (CKD) prognosis are associated with improved patient care and decreased surrogate burden, they reportedly occur infrequently. Most Nephrology training programs lack dedicated communication skills training (CST), and graduating fellows feel unprepared for these difficult conversations. Simulated conversations using standardized patients are effective in CST but are costly, and it is difficult to find and train committed actors. Alternatively, incorporating sociodrama techniques have been successful in Oncology CST. Sociodrama involves group members enacting social situations guided by a facilitator using techniques (primarily role-play, role reversal, and doubling--revealing unspoken thoughts and feelings) to enhance learning.
Methods
We developed a one-day, sociodramatic, facilitator-led nephrology CST workshop. Workshops began with warm-up exercises to reduce anxiety and promote participation. Learners are then guided in enacting the clinical scenarios they find most challenging. Key communication skills are taught during these role-plays. Topics included giving bad news, discussing prognosis, eliciting goals of care, and addressing family concerns. Strategies included were giving information and assessing understanding as well as responding to emotion with empathic statements (e.g. ‘tell me more”, and ‘I wish’ statements). Participants were asked to complete surveys anonymously after the workshop.
Results
24 surveys (18 trainees and 6 faculty) were collected in 2017 and 2018. Although 42% of participants were apprehensive of sociodramatic enactments, only 17% had some difficulty. 100% of responses indicated that sociodrama enhanced learning and 92% indicated plans to incorporate learned skills into practice with 75% interested in further CST. Participants also indicated the day-long session to be lengthy.
Conclusion
Teaching communication skills in nephrology utilizing sociodrama is feasible, effective, and economical. Most participants found the workshop effective and intended to incorporate learned skills into practice. Follow-up surveys are needed to determine whether participants have used learned skills. Incorporating CST in an abridged format intermittently in the context of fellowship training may further increase the impact of this training.