Jennifer L. Ayres, Ph.D., HSP & Joe Grasso, MA UT Southwestern Austin Family Medicine Residency Program

* Communication seminar * Goals & outcome measurements * Topic areas * Structure * Examples

* Fellowship learning contract component * Provide structured learning experience to supplement clinical encounters * Address communication challenges identified during direct observations * And, most importantly…

* Good communication with physician results in… * Higher satisfaction (Silverman et al, 2006) * Improved treatment adherence & outcomes (Bensin, 1991) * Reduced use of health resources (Kurtz et al, 2005) * Patient’s empowerment while feeling that doctor is handling situation effectively (Wright et al, 2004) * Patient’s perception that physician is interested & views patient as a partner (Epstein, 2006, 2004)

* Teach practical skills * Encourage self- reflection * Improve patient care & satisfaction * Group cohesion * Safety * Balance between introverts & extraverts * Fun

What is communication? Nonverbal info Agendas Translating Reflective listening Basic Delivering bad news Sadness & anger Talking to kids Psychiatric complexity Chronic pain Advanced Cultural lens Countertransference What is my contribution to the communication breakdown? Self- Reflection Seminar Topics

* Didactic lecture/discussion (30 min) * Practical application exercise (30 min) * Traditional role play * Team doctor variation

1. First person  Patient or Physician? 2. “Physician”  * Ability to choose between initial v. continuity encounter * Ability to call time-out for consults * Ability to call for a rewind * Facilitator’s ability to model 3. Individual v. Group Physician 4. Specific feedback about skills

* Behavioral health attending * Shadow residents during patient encounters * Structured evaluation form * Provides opportunity for in-vivo modeling & generalization of seminar content * Provides opportunity for linkage to BH services

Self- Reflection Personal Experience Immediate Reaction

Patient Factors Dr-Patient Factors Doctor Factors

Jennifer Ayres, Ph.D UT Southwestern Austin Family Medicine 1313 Red River, Suite 100 Austin, TX 78701