"Mastering the Difficult Conversation" Communications Course: Utilizing OSCEs and Workshops to Prepare Learners for Residency.

Abstract

Introduction: Physicians frequently face challenging conversations, yet medical education often inadequately prepares them for discussions on health literacy, behavior change, and end-of-life care. To bridge this gap, the Medical College of Wisconsin created the "Mastering the Difficult Conversations" online elective for senior medical students. This study analyzes the course's effectiveness in enhancing communication skills training.

Methods: A 4-week, online elective utilized interactive workshops and formative Objective Structured Clinical Examinations (OSCEs) addressing four themes: overcoming health literacy barriers, managing agitated patients, inspiring behavior change, and delivering bad news. Students engaged in prereading, role play, and reflection. Zoom-based OSCEs with standardized patients and faculty provided immediate feedback. We analyzed qualitative data from 35 reflection papers over 4 years and quantitative standardized assessment data.

Results: Results indicated five primary themes from reflection papers: goals, empathy, lessons learned, identified strengths, and positive remarks. Anonymous evaluations showed high student satisfaction, with the course meeting its objectives of enhancing communication skills and professionalism.

Conclusion: This study confirms that a structured communication program with interactive discussions and formative OSCEs improves medical students' preparedness for difficult patient interactions. The Zoom-based format proved a viable and favorably rated educational tool, replicable across distances. Despite limitations such as sample size and the need for longitudinal data, these findings highlight the importance of expanding structured communication curricula to enhance patient outcomes and physician well-being.