Introduction: Providing students with feedback about their strengths and areas for improvement for ACGME competencies is often challenging in the busy graduate medical education environment. We created this counseling practicum curriculum to provide immediate teaching moments and a real-time assessment window for resident performance in the ACGME core competencies of interpersonal and communication skills, patient care, and medical knowledge as relevant to the social and behavioral sciences. Methods: This is an 18-month longitudinal curriculum where family practice residents meet every other month for a half-day practicum with an assigned cohort. During each half-day, one resident in each cohort counsels one of their own patients for an hour-long session while receiving simultaneous, live supervision via closed circuit video monitoring by behavioral science faculty preceptors and their cohort peers. Each session is structured with a brief presession planning meeting, a midsession break during which residents receive brief feedback and direction, and a postsession debriefing meeting. Results: Early results of a pilot study to evaluate the impact of this curriculum on resident empathy, communication, and relationship skills has shown the curriculum resulted in: (1) differences in patient/physician perceptions of their relationship, (2) improvements in the effectiveness of physician/patient encounters from the first year, and (3) improvement in physicians’ counseling skills from the first year. Discussion: Despite scheduling challenges and initial resident anxiety and resistance, we created an effective longitudinal curriculum for improving residents’ communication skills and understanding of psychosocial and behavioral medicine. Confidence increases as the residents become more comfortable with their cohort, and the formative learning environment, both of which are critical to the success of this curriculum.
By the end of this curriculum, learners will be able to:
- Gain knowledge of psychosocial issues and their impact on health, illness, and the doctor-patient relationship; and their own counseling style, including their strengths and weaknesses.
- Increase skills in assessing the impact of the psychosocial context of their patient's health; eliciting the patient's story; responding to patient's emotions; developing relational connections with their patients; the use of genograms; and, integrating biomedical and psychosocial aspects into treatment.
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