A Human Factors Curriculum for Surgical Clerkship Students

Hypothesis: Early introduction of a full-day human factors training experience into the surgical clerkship curriculum will teach effective communication skills and strategies to gain professional satisfaction from a career in surgery. Design: In pilot 1, which took place between July 1, 2007, and December 31, 2008, 50 students received training and 50 did not; all received testing at the end of the rotation for comparison of control vs intervention group performance. In pilot 2, a total of 50 students were trained and received testing before and after rotation to examine individual change over time. Setting: University of Massachusetts Medical School. Participants: A total of 148 third-year medical students in required 12-week surgical clerkship rotations. Interventions: Full-day training with lecture and small-group exercises, cotaught by surgeons and educators, with focus on empathetic communication, time management, and teamwork skills. Main Outcome Measures: Empathetic communication skill, teamwork, and patient safety attitudes and selfreported use of time management strategies. Results: Empathy scores were not higher for trained vs untrained groups in pilot 1 but improved from 2.32 to 3.45 on a 5-point scale (P < .001) in pilot 2. Students also were more likely to ask for the nurse's perspective and to seek agreement on an action plan after team communication training (pilot 1, f = 7.52, P =. 007; pilot 2, t = 2.65, P =. 01). Results were mixed for work-life balance, with some trained groups scoring significantly lower than untrained groups in pilot 1 and no significant improvement shown in pilot 2. Conclusions: The significant increase in student-patient communication scores suggests that a brief focused presentation followed by simulation of difficult patient encounters can be successful. A video demonstration can improve interdisciplinary teamwork.