Educational Purpose and Goals
Effective communication and interpersonal skills are cornerstones of physicians' professional identities.  The successful internist must be able to establish therapeutic doctor-patient relationships, work within multidisciplinary teams, and communicate verbally and in writing in a manner that facilitates patient care.  In addition, internal medicine residents must act as teachers of other residents and students.


Principle Teaching Methods
Supervised Direct Patient Care Activities

During clinical activities, residents observe physicians and other personnel modeling effective communication and interpersonal skills, and are observed in their turn.  Such modeling may occur during bedside rounds, clinic visits, family meetings, case conferences, documentation activities or while performing care-oriented tasks. 

Teaching Rounds and other small group discussions

Residents provide concise oral presentations of patient history and physicals, participate in academic discussions of medical issues, and perform problem-focused histories and physicals during teaching rounds for general medicine inpatient and ICU rotations.  Faculty moderates these discussions.  Similar interactions occur in a variety of other small group formats throughout the three years of residency, and may include ancillary personnel participation.
 

Clinical Skills Assessment

Each resident undergoes a videotaped patient H&P that is later reviewed by the resident together with a faculty member.  Residents are trained in HIPPA requirements regarding confidentiality of communicated data.

Required presentations

All residents must complete a scholarly project during their training. The end product may be an oral presentation, poster, publication or interesting case report and review of the literature. These will be presented at the Annual Resident Research Seminar or the Rizzo Competition.
PGY 3 residents are required to deliver a lecture focusing on an interesting case, recent research findings or a topic assigned by a supervising faculty member. PGY 2 and 3 residents must attend seminars highlighting their communication roles as teachers of medical students.  

Educational Content
Orientation: Communication skills will be reviewed at orientation with an emphasis on the importance of accurate sign-out/, transfer of patient information, HIPPA regulations, coding issues, giving bad news and medical errors. Expected areas of emphasis include actively listening, organization of information succinctly and efficiently, use of appropriate language, use of technology for information exchange, and writing legibly.

Web-based: A web-based curriculum on communication skills will be offered, with modules to be completed throughout the residency.

Physician-Patient relationships: The resident will gain experience and knowledge in educating and counseling patients and their families, including developing diagnostic and therapeutic plans using informed decision making that are culturally sensitive.

Team work: In fulfillment of their duties, residents must work with personnel at a variety of levels within the system, both as a team member and leader 
 

Principle Ancillary Educational Materials
Role modeling: Throughout the residency, emphasis will be placed on observation of role models for interpersonal and communication skills.

Methods of Evaluation  

Resident Performance will be monitored by attending faculty who will complete web-based resident evaluation forms assessing interpersonal and communication skills.  All evaluations are available for on-line review by the resident at their convenience, and are sent to the residency office for internal review.  The evaluations are kept as part of the resident file and are revewed with the resident at the 6 month interviews.

Program and Faculty performance are completed  by the residents anonymously on a web-based form and are reviewed with the faculty once a year.

Interpersonal and Communication Skills Competency-Specific Objectives
PGY 1 residents should:

• Be able to successfully negotiate nearly all difficult patient encounters with minimal direction.
• Function as team leaders with decreasing reliance on attending physicians.
• Function as a consultant, including completion of appropriate documentation and verbal communication with the requesting physician, whether serving as a consultant for general internal medicine or when on an elective.