As value-based care becomes the new standard in today’s shifting healthcare environment, the role of communication in radiology is expanding. Effective communication is vital in demonstrating radiology’s value, particularly to patients, who oftentimes are not aware of the role radiologists play in their care. That’s why the ACR Commission on Patient- and Family-Centered Care recently launched the Radiology Resident Communications Curriculum, a free resource designed to teach residents effective interpersonal skills and help residency programs comply with communication requirements.
“From a business perspective, it makes sense for us to start communicating more,” says David S. Sarkany, MD, program director of radiology residency at Staten Island University Hospital. “So patients understand that the name at the end of the report is a person, a specialist.”
This newfound emphasis on communication, however, is not a natural transition for many radiologists, who are often referred to as the “doctor’s doctor” due to their seemingly exclusive interaction with other physicians and healthcare providers. “Historically, radiologists have not had as much face-to-face interaction with patients, so they’re sometimes out of practice,” says Carolynn M. DeBenedectis, MD, associate professor of radiology and residency program director at the University of Massachusetts. “However, now there’s a huge push for more face-to-face interaction, so they’ll have to communicate with patients more.”
With the professional stakes so high and experience levels often low, providing additional training in communication for radiologists should be in place. And yet, formal communication training is almost non-existent in national radiology residency programs.
To fill this gap, the curriculum was developed. The intensive program, which launched in August 2018, includes module-based learning, patient-doctor simulations, skills assessments, and sample case studies in communication.
The curriculum provides confidence and comfort for residents and allows them to practice having critical discussions with patients.
The curriculum’s purpose is twofold: 1) it provides residents with a skill necessary for their future success, and 2) it provides residency program directors with assessment tools to show compliance with ACGME requirements that mandate residents demonstrate proficiency in the essential radiology milestones of interpersonal and communication skills.
“The curriculum provides confidence and comfort for residents,” says DeBenedectis, “and allows them to practice having critical discussions with patients.” Because conversations between patients and radiologists often involve unpleasant news — such as a cancer diagnosis or telling a parent that their child is sick — they can be highly emotional. As such, the required level of expertise and empathy can be daunting for radiologists untrained in effective communication skills, DeBenedectis says.
According to Sarkany, one distinguishing feature of the curriculum is the interactive component in which residents role-play in fictitious scenarios. “This is an area of medicine that you can’t really teach by giving a lecture,” says Sarkany. “But if you put the resident into a scenario where they don’t know what they’re walking into — that's when they really get to practice the intangible aspects of being better communicators.”
Sarkany notes that some of these intangible aspects include sitting down with the patient at eye level instead of standing, asking open-ended questions, repeating yourself, asking patients if they understand, reading body language, and avoiding medical jargon.
Finally, the curriculum is customizable, allowing program directors the flexibility to add as much, or as little, content to their existing curricula as they choose. For instance, the scenarios in the interactive component can be portrayed either by professional actors or residents trained to play those roles. The information can also be presented in video form.
“Not all programs are the same,” says DeBenedectis. “We’ve created the curriculum so you can tailor it to your facility and your resources and still get a similar benefit.”
The ideal implementation of this curriculum would be early in a residency program, so residents can repeat and hone these skills over time. However, there is no wrong time to teach these skills. According to DeBenedectis, “The only wrong thing to do would be not to train residents in these vital patient-centered skills.”