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Communication Skills for Surgeons: A Contemporary Guide

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Historically, communication was described as a secondary, or ‘soft skill’ for surgeons. Now, astute communication, both with patients and with colleagues, forms a fundamental element of holistic surgical practice and comprises a core component of the ‘Non-Technical Skills for Surgeons’ that are increasingly recognised in modern surgical practice.

Good communication is required during each patient interaction: history taking, explanation, consent, breaking bad news, and managing difficult encounters such as the demanding or angry patient. Good communication with patients improves patient trust, compliance and overall satisfaction, reduces complaints and malpractice claims.


High quality communication is also fundamental when interacting with colleagues: in theatre, on the ward, whilst making referrals and organising special tests. In the busy schedules of medical professionals, such communication must be succinct and relevant. Team structures must empower all members to speak up, so as to prevent harm being done. Suboptimal communication is a root cause for the majority of serious adverse events. Furthermore, good communication reduces job stress and enhances satisfaction for the surgeon.

Good communication is not an inborn behaviour; it is a learned skill that is based on key principles. Studies have clearly demonstrated that education in communication improves patient outcomes and satisfaction. Several frameworks have been described, to facilitate good communication in certain scenarios: SPIKES for breaking bad news, SBAR for handover, surgical briefs and de-briefs, to name a few.


This textbook will be aimed towards medical students, surgical trainees and surgical consultants internationally. It is relevant to every-day practice, examinations and OSCEs, such as medical finals, MRCS, FRCS and international equivalents, and interviews where role play is often featured.

Author(s): Benjamin Patel, Abhay Rane
Publisher: Springer
Year: 2022

Language: English
Pages: 154
City: Cham

Preface: The Importance of Communication in Surgery
Contents
Part I Key Concepts in Surgical Communication
1 The Components of Communication
Introduction
References
2 The Patient-Surgeon Relationship
The Importance of the Patient-Surgeon Relationship
Models of Patient-Surgeon Relationship
Ethical Perspective
How to Strengthen the Patient-Surgeon Relationship
Professional Boundaries and Difficult Relationships
Conclusions
References
3 Teamwork in Surgery
Introduction
Definitions: What Are Teams, Teamwork, and Team Performance?
Team Structures
Characteristics of Effective Teams
Organizational Structure
Individual Contribution
Team Processes
Summary
References
4 Trainer-Trainee Relationship
Introduction
The Learning Curve and Repetitive Training
Barrier’s to Training and Dysfunctional Trainer-Trainee Relationship
Undermining and Bullying
Attributes of a Good Surgical Trainer
Different Training Styles
Different Learning Patterns
Evidence Based Suggestions for Improving Trainer-Trainee Environment
Learning by Observing and Assisting
Conclusion
References
Part II Scenarios and Frameworks: Patient–Surgeon
5 Information Gathering and Diagnostics
Introduction
Components of the Surgical History
The Presenting Complaint
The History of the Presenting Complaint
The Past Medical History
The Drug History
The Family History
The Social History
Open Style Questions
Summarising
Ideas, Concerns and Expectations
Ideas
Concerns
Expectations
Example Scenario: PR (Per Rectal) Bleeding
Conclusion
References
6 Shared Decision-Making and Consent
Introduction
Law and General Approach
Scenarios
References
7 Breaking Bad News
Introduction
Scenario 1: Cancer Diagnosis
Scenario 2: Death of a Relative
Reference
8 Escalation Status and Palliative Care
Background
Definitions, Legal Frameworks and Guidelines
Escalation Discussions with Patients and Family
Escalation Discussions with Colleagues
Conclusion
References
9 Navigating Patients’ Emotions
The Role of Healthcare Professionals
Structure
Scenario 1: Angry Patient
Scenario 2: Anxious Patient
Summary
10 Communication with Young People
Background and Law
What is Gillick Competency?
Refusal of Treatment
Scenario 1: Gillick Competent Refusal of Treatment
Scenario 2: Gillick Incompetent Refusal of Treatment
References
11 Communication with Patients with Learning Disabilities
Introduction
Helpful Tips
Consenting Patients with Learning Disabilities
Conclusions
References
Part III Scenarios and Frameworks: Teamwork and Teaching
12 Referrals and Requests
Introduction
Scenario 1: Intensive Care Unit
Referral
Conclusions
Scenario 2: Tertiary Centre Referral
Referral
Conclusion
Scenario 3: Radiology Request
Request
Conclusion
Scenario 4: Overnight Escalation to Consultant
Call to Consultant
Conclusions
References
13 Communicating in Theatre
Introduction
Surgical Brief
WHO Checklist
De-brief
References
14 Responding to Significant Events
Introduction
Prevention of Significant Events
Responding to Significant Events
Supporting Colleagues
Conclusion
References
15 Surgical Training and Feedback
Introduction
How Do You Define Feedback?
Neurophysiology of Feedback
Who Can Give Feedback?
Types of Feedback
Feedback Models
Curriculum Assessment Tools
Factors Responsible for Effective Feedback
Barriers to Effective Feedback
Recommendations for Giving and Receiving Effective Feedback
Conclusion
Textbox Tips
References
16 Handover and Presenting Patients
Handover
Presenting Patients
References
17 Reflective Practice
Introduction
What is Reflection?
Models of Reflection
Reflective Practice as a Trainee
Reflective Practice as a Non-training Grade Surgeon
Informal Reflective Practice
Reflective Practice as Evidence
Reflective Practice and Bawa-Garba Case
GMC Guidelines for Reflective Practice and Suggestions, Tools and Guidance on “How to Reflect”
References
Part IV Communication Using Technology
18 Communication in Telehealth
Introduction
Telereferral
Teleconsultation
Tips for Teleconsulting
Diagnostics
Telesurgery
Post-operative Monitoring
Telementoring and Teleproctorship
Communication in Telementoring
Legal Considerations in Telehealth
Conclusion
References
19 Communicating with Social Media
Introduction
Social Media Classification
Applications of Social Media
Problems and Pitfalls with Communicating on Social Media
Success in Social Media
Conclusion
References