Aim This study aimed to assess the trends in psychotropic drug prescriptions among elderly residents with dementia following the continuous implementation of multimodal comprehensive care communication skills training for staff in a long-term care facility. Methods This retrospective single-center cross-sectional study utilized the database of an urban public hospital that included a long-term care facility. The data were collected from 2016 to 2020. All 130 staff members at the hospital (52 nurses, 48 professional caregivers, seven rehabilitation staff members, three physicians, and three pharmacists) initiated multimodal comprehensive care communication skills basic training from October 2014 to December 2015, which was followed by continuous monthly training until the end of 2020. Antipsychotic prescription rates for residents aged over 65 years with dementia were measured throughout the study period. Results A total of 506 eligible residents were identified, the median age was 86.0 years (IQR: 81.0-90.0), and 283 (55.9%) residents were females. The prescription rates for psychotropic drugs among residents with dementia decreased significantly (43.5% in 2016, 27.0% in 2020; p=0.01). Notably, the percentage of patients prescribed anxiolytics decreased significantly (from 4.7% to 0.0%), while the percentage of patients receiving antipsychotic drugs, hypnotics, antidepressants, or antiepileptic drugs remained unchanged over time. The prescription rates for antidementia drugs significantly decreased from 15.3% to 4.0%. Conclusion The prescription rates of psychotropic drugs were significantly reduced following multimodal comprehensive care communication skills training for staff at a long-term care facility. The improvement in communication skills among staff at long-term care facilities has a tangible impact on reducing drug use among elderly residents with dementia.

BACKGROUND: Medical communication skills are a critical component of clinical medicine and patient satisfaction. Communication skills are difficult to teach and evaluate, necessitating tools that are effective and efficient. This study presents and validates the 7 Elements Communication Rating Form (7E-CRF), a streamlined, dual-purpose, evidence-based medical communication checklist that functions as a teaching and assessment tool.
METHODS: A 14-item teaching and assessment tool is described and validated using face, concurrent, and predictive validity indices. The study was conducted with 661 medical students from the West Virginia School of Osteopathic Medicine (WVSOM). Student performance was assessed in year 1 labs, year 2 labs, and year 2 and year 3 objective structured clinical examination (OSCE). These internal indices were compared with student performance on the Humanistic Domain of the Comprehensive Osteopathic Medical Licensing Examination (COMLEX) Level 2-Performance Evaluation (PE), a licensure exam previously taken in years 3 or 4 of osteopathic medical schools.
RESULTS: The evidence of interrater reliability and predictive validity is strong. Data from the 7E-CRF is compared to performance on the COMLEX Level 2-PE, Humanistic Domain. The 7E-CRF can identify students who are at a 10-fold increased risk of failure on the COMLEX Level 2-PE Humanistic Domain.  Conclusions: The 7E-CRF integrates instruction and assessment, based on a national and international model. The simplicity, foundation in professional consensus, ease of use, and predictive efficacy make the 7E-CRF a highly valuable instrument for medical schools in teaching and evaluating competency in medical communication skills.

UNASSIGNED: Communication skills are essential to providing patient-centered care. The need for standardized communication skills training is at the forefront of medical school and residency education. We aimed to design and implement a curriculum teaching virtual communications skills to medical students. The purpose of this report is to describe our experience and to offer guidance for training programs developing similar curricula in the future.
UNASSIGNED: The curriculum was presented in weekly modules over 5 weeks using Zoom technology. We focused on proven strategies for interacting with patients and other providers, adapted to a virtual platform. Skill levels during role-play were assessed by the Simulated Participants and students observing the simulation using the 14-item, physician specific Communication Assessment Tool (CAT). The primary outcome of the CAT is the percentage of \"excellent\" for each item ranked both years. Participants provided feedback on what worked well or how the module could be improved in open-ended responses.
UNASSIGNED: Twenty-eight and 25 students registered for the course in Year 1 and Year 2, respectively. Students\' post-session confidence in their ability to perform target skills was statistically higher than their pre-session scores in most sessions. Modules with the lowest pre-session confidence for both years were \"Disclosing a Medical Error\" and \"Responding to Patient Bias.\" The mean percentage of students receiving \"excellent\" scores on individual CAT items ranged from 5 to 73% over the course of both years. Verbal and written feedback in Year 1 provided direction for the curriculum developers to improve the course in Year 2.
UNASSIGNED: Developing and implementing a new education curriculum is a complex process. We describe an intensive curriculum for medical students as we strive to allow students extra \"clinical\" time during COVID-related restriction. We believe continued focus on patient and family communication skills will enhance patient care.
UNASSIGNED: The online version contains supplementary material available at 10.1007/s44186-022-00054-9.

BACKGROUND: To continue education during the COVID-19 pandemic, we implemented a Virtual Education Platform (VEP) and Virtual Visiting Professorship (VVP) in March 2020 into our plastic surgery residency curriculum. This study investigated resident and guest speaker perceptions of the VEP since the start of the pandemic.
METHODS: The VEP consists of weekly VVP lectures and usual conferences held over Zoom. In May 2020, residents and speakers completed surveys that assessed the perceptions of the VEP using a 5-point Likert scale and open-ended responses. In August 2021, residents also completed follow-up surveys.
RESULTS: A total of 19 (100%) residents and 10 (100%) speakers responded to the 2020 surveys and 15 (88.2%) residents responded to the 2021 follow-up survey. Speakers represented nine academic institutions, one international. 74% of residents responded that they learned a lot or a great deal from the VVP. In 2021, 100% of residents agreed that virtual conferences should remain a core component in PRS residency education, even after social distancing requirements subside. The VVP lectures were mentioned as the most helpful lectures in both years. Easy accessibility without travel time was the most mentioned advantage of the VEP in both years, with significantly more residents citing this benefit in 2021 (p = 0.0076). The most reported disadvantage for residents was the lack of social interaction and community in both years, with significantly more residents in 2021 citing this as a disadvantage (p = 0.0307). Residents\' attitudes also shifted such that significantly more residents liked and were satisfied with the VVP lectures from 2020 to 2021 (p = 0.04).
CONCLUSIONS: Over a year into the COVID-19 pandemic, resident perceptions of a virtual education platform and virtual visiting professorship were very positive. The quick development, implementation, and high efficacy of these educational experiences underscore that learning is possible in alternative forms in unprecedented times.

BACKGROUND:  The extent of empathy is an individual human property, not completely dependent on cognitive intelligence. People arise with certain genetic fundament for empathy but the ability to perceive empathically develops further during the life. There has been much discussion in the medical literature about the importance of empathy and physician communication style in medical practice. Empathy has been shown to have a very real positive eff ect on patients outcomes. The literature suggests that empathy training is warranted and should be incorporated into surgical residencies through didactics, role-playing and simulations, and apprenticeship to empathic attending role models.
OBJECTIVE: This paper reviews empathy and its importance as it pertains to the physician-patient relationship and improving patients outcomes, and the need for increased education in empathy during medical training.

OBJECTIVE: The aim of this systematic scoping review is to examine and synthesise the available literature on developing interpersonal and communication skills in general nursing preceptorship education programmes.
BACKGROUND: Highly developed interpersonal and communication skills are an essential component of nursing preceptorship. Preceptors are integral in facilitating, guiding, and developing positive interpersonal relationships between the nursing student (the preceptee), the qualified nurse (the preceptor), and patients. They also have a responsibility to foster and develop preceptees\' interpersonal and communication skills and assess and deem preceptees as competent in such skills. Furthermore, preceptors require effective interpersonal and communication skills to carry out key responsibilities of their role, including creating a safe clinical learning environment, teaching, and providing effective feedback.
METHODS: A scoping review was conducted using the methodological framework of Arksey and O\'Malley. The PRISMA Extension for Scoping Reviews guided the reporting.
METHODS: Five electronic databases were searched for relevant articles in consultation with a librarian, supplemented by hand-searching and internet searches for grey literature. A total of 19,431 potentially relevant articles published between Jan 2000 and August 2021 were retrieved from the initial search, and an additional six articles were obtained from the supplemental search. A total of 146 articles were independently reviewed by two researchers, resulting in 24 articles eligible for inclusion in the review.
RESULTS: Several themes were identified in the literature that influenced the development of interpersonal and communication skills in preceptorship education and training programmes, including design and development of programmes, key learning outcomes, pedagogical approaches of preceptorship education and training programmes and interpersonal & communication skills development in preceptorship education and training programmes. Conclusions This review highlighted that research on developing interpersonal and communication skills amongst preceptors is mainly absent from the literature. Further research to address these knowledge gaps is warranted. The results from this review can be used to inform future curriculum design and development of nursing preceptorship education and training programmes.

Background Trainers in surgery have an educational obligation to train trainees in performing operative procedures. Objective We hypothesized that poor concordance manifests as discrepancies between the trainee and the trainer, with an associated reduction in satisfaction with the training experience, perception of training quality, and completion of workplace-based assessments (WBAs). This study also aimed to validate the novel Supervised Training Operative Procedure (STOP) online tool. Method We developed an online proforma (STOP online tool) and conducted a prospective, single-blinded study of 53 orthopedic operative procedures with 53 trainees between January 19, 2019, and August 27, 2019. Results Forty-four (82%) trainees were listed as the primary surgeon. The overall mean trainee satisfaction (on a 0-10 Likert scale) was 8.25 (range: 3-10), and the mean trainer satisfaction was 8.28 (range: 4-10). A preoperative discussion between the trainee and the trainer occurred in 96.2% of the cases. Forty-eight (91%) trainers preoperatively established trainees\' objectives and 91% (n = 48) of the cases showed postoperative completion of objectives. Forty-four (83%) trainers anticipated workplace-based assessment (WBA) completion for trainees, and this translated into 41 (77%) completed WBAs. Overall, 47 (92.9%) trainees felt that the STOP tool would be useful as a surgical training checklist and in the completion of WBAs. Conclusion The STOP checklist is useful in understanding qualitative and quantitative measures of the overall trainee performance of an operative case. This holistic approach will enable us to establish a structured perioperative surgical training checklist, as trainee and trainer requirements are dependent on one another.

To understand the variability of surgical attending experience and perspectives regarding informed consent and how it impacts resident education DESIGN: A novel survey was distributed electronically to explore faculty surgeon\'s personal learning experience, knowledge, clinical practice, teaching preferences and beliefs regarding informed consent. Chi-square and Kruskal-Wallis testing was performed to look for associations and a cluster analysis was performed to elucidate additional patterns among.
Single, tertiary, university-affiliated health care system (Yale New Haven Health in Connecticut), including 6 teaching hospitals.
Clinical faculty within the Department of Surgery.
A total of 85 surgeons responded (49% response rate), representing 17 specialties, both private practice and university and/or hospital-employed, with a range of years in practice. Across all ages, specialties, the most common method for both learning (86%) and teaching (82%) informed consent was observation of the attending. Respondents who stated they learned by observing attendings were more likely to report that they teach by having trainees observe them (OR 8.5, 95% CI 1.3-56.5) and participants who recalled learning by having attendings observe them were more likely to observe their trainees (OR 4.1, 95% CI 1.5-11.2).Cluster analysis revealed 5 different attending phenotypes with significant heterogeneity between groups. A cluster of younger attendings reported the least diverse learning experience and high levels of concern for legal liability and resident competency. They engaged in few strategies for teaching residents. By comparison, the cluster that reported the most diverse learning experience also reported the richest diversity of teaching strategies to residents but rarely allowed residents to perform consent with their patients. Meanwhile, 2 other cluster provided a more balanced experience with some opportunities for practice with patients and some diversity of teaching- these clusters, respectively, consist of older, experienced general surgeons and surgeons in trauma and/or critical care.
Surgeon\'s demographics, personal experiences, and specialty appear to significantly influence their teaching styles and the educational experience residents receive regarding informed consent.

Hispanic Americans are the fastest growing ethnic group in the United States, with an ever-growing gap in the communicative capacity between patients and healthcare providers. This leads to linguistic marginalization and worse healthcare outcomes. There is an increasing need for Spanish literacy in healthcare professionals, including medical students. However, approximately half of medical schools don\'t offer a Spanish elective. We performed a scoping review of the literature to assess the relationship between medical Spanish electives, verbal fluency, auditory comprehension, and student comfort. This study was conducted using PubMed and Google Scholar to evaluate articles on Spanish electives in medical schools. Nine articles met inclusion criteria. Almost all studies demonstrated benefit as per outcome measures assessed with statistical significance. The available literature supports the need for Spanish elective courses, with numerous advantages conferred, e.g. increased self-perceived knowledge about specific health issues in the Hispanic American community and reduction in inadvertent communication errors in the patient-provider-interpreter interaction. However, most of the reports analyzed exhibited numerous limitations that warrant future research studies in order to eliminate variables such as bias and issues with generalizability. The authors suggest that more medical schools offer virtual Spanish electives with a focus on empathetic language strategies and patient satisfaction.

Shifts in American healthcare delivery mechanisms pose significant hurdles to new physicians. Surgeons are particularly susceptible to these changes, but surgical residency educational efforts primarily focus on technical and clinical training to the exclusion of business and management practices. This study conducted a needs assessment of perceived gaps in practice management skills among early career surgeons to guide future training curricula.
This study was an exploratory qualitative study following the Consolidated Criteria for Reporting Qualitative Research. Purposive sampling was used to identify early career (<5 years following fellowship completion) surgeons across the United States. A semi-structured interview guide was created from interviews with surgical administrators and physician administrative curricula. Transcripts were de-identified and analyzed using a constructivist grounded theory approach.
Ten surgeons from 6 specialties and 6 institutions were interviewed along with 3 surgeon administrators. Three major domains of need were identified: (1) fundamentals of procedural coding, clinical billing, & compliance, (2) finding/building a practice, and (3) navigating organizational challenges. First, surgeons thought trainees would benefit from a better understanding of reimbursement schema and the basics of health policy. They also thought that more exposure to malpractice litigation, especially for handling case review or expert witness requests, would be helpful for discerning how to handle such issues early in their career. In addition, early career surgeons expressed a desire to have dedicated mentorship time, a primer on evaluating job offers with simulated contract negotiation, and guidance regarding administrative roles. Finally, surgeons requested training in change management techniques, care pathway construction, and the basics of staffing decisions.
There are significant practice management gaps in surgical training which may be amenable to targeted educational efforts during a residency or fellowship program. Future research will test the generalizability of these findings as well as build curricula that adequately meet these needs.