Why Is This Needed?
   
    We as anesthesiologists sensed a need for 
    improvement in mutual communication skills
     Surgical chiefs agree this need is present
   
    Effective communication is one of the 6 core 
    competencies that must be demonstrated for 
    successful completion of residency
   
    Poor teamwork and communication are key 
    factors responsible for medical errors
     Poor communication identified as the root cause           
                   of 35% of anesthesia-related sentinel events
                   Can Communication Be Taught?
       
           Some might say “you can’t teach an old dog new 
           tricks,” but…
       
           Students are interested in learning about this…
            In a study that surveyed Iranian medical students, positive 
               attitudes toward learning communication skills were more 
               prevalent than negative attitudes
            Interestingly, positive attitudes were more prevalent and 
               negative attitudes less prevalent in female medical students 
               and those in the basic science portion of their training
                  Indicates that we enter medical school knowing that 
                   communication is important, but it seems to be lost on us later in 
                   our training
       
           And specific interventions for physicians have been 
           successful (see next slide)…
                  Teaching Communication Skills
      
          In a 2011 study, oncologists were randomly 
          assigned to a brief palliative care-focused 
          communication skills training course using 
          patient actors
           11-hour workshop in small groups followed by 30 
              minutes of individual coaching
           Pre- and post-intervention assessments of skills
           Intervention improved communication skills 
              significantly and with moderate to large effect size
                 Both global communication skills and skills with respect 
                  to palliative care discussions were improved
            Communication and Conflict
   
     Breakdowns in communication are one of the 
     most frequent causes of conflict in health care
      Unresolved conflict in turn creates an impediment to 
       communication and undermines the teamwork that is 
       necessary for good patient care
   
     The OR is at risk for conflict because:
      There are many different professionals with overlapping 
       and sometimes poorly delineated responsibilities
      Two physicians sharing equal responsibility for patient
      Complex, high-pressure work environment
      Sleep deprivation and stress affect interactions
      Ethical conflicts and conflicts of interest may emerge
   Anesthesia-Related Sources of Conflict
   
     Postponement/cancellation of cases
      How we communicate this to surgeons can potentially 
       have a positive or negative effect on how they 
       perceive it
      Some information is usually lost in the interaction
   
     Changing anesthesiologist assignment just 
     before the beginning of a case
   
     Double-coverage causing delays in induction 
     and emergence