Optimizing Resident Confidence in Delivering Bad News: The Impact of Timing in Communication Curriculum

Abstract

This study aims to determine whether the timing of a VitalTalk communication workshop during the academic year affects internal medicine residents’ confidence and stress in serious illness conversations (SICs), and to assess differences by postgraduate year (PGY). It is a single-center, community hospital, retrospective pre-/post-test survey design. Thirty-six medicine residents (PGY1-3+) participated in mandatory half-day VitalTalk workshops delivered in the fall, winter, or spring. Surveys assessed self-perceived confidence and anticipatory stress regarding SICs, breaking bad news, and goals-of-care discussions using 11-point Likert scales. Paired sample t-tests compared pre- and post-workshop responses; one-way ANOVA compared gain scores across PGY levels and cohorts. Across all participants, confidence in SICs increased significantly after the workshop (mean change +1.21, P < 0.01), with improvements observed across all PGY levels and cohorts. No significant differences in confidence gains were detected between groups. Anticipatory stress did not change significantly overall; however, PGY2 residents experienced a significant reduction in stress for both goals-of-care (mean change −1.27, P = 0.015) and breaking bad news (mean change −1.45, P = 0.007). We conclude that the timing of a communication workshop within the academic year was not associated with changes in confidence or stress among all residents. Among graduate years, PGY2 residents showed the most significant stress reduction. These findings suggest there is no association between confidence, stress, and the timing of a SIC VitalTalk workshop during the academic year. PGY2 residents reported the greatest stress reduction from this workshop, suggesting that this year may be the optimal time to introduce a novel communication curriculum.