Communication as a High-Stakes Clinical Skill: "Just-in-Time" Simulation and Vicarious Observational Learning to Promote Patient- and Family-Centered Care and to Improve Trainee Skill.

Patient-provider communication is a hallmark of high-quality care and patient safety; however, the pace and increasingly complex challenges that face overextended teams strain even the most dedicated clinicians. The COVID-19 pandemic has further disrupted communication between clinicians and their patients and families. The dependence on phone communication and the physical barriers of protective gear limit nonverbal communication and diminish clinicians' ability to recognize and respond to emotion. Developing new approaches to teach communication skills to trainees who are often responsible for communicating with patients and their families is challenging, especially during a pandemic or other crisis. "Just-in-time" simulation-simulation-based training immediately before an intervention-provides the scaffolding and support trainees need for conducting difficult conversations, and it enhances patients' and families' experiences. Using a realistic scenario, the author illustrates key steps for effectively using just-in-time simulation-based communication training: assessing the learner's understanding of the situation; determining what aspects of the encounter may prove most challenging; providing a script as a cognitive aid; refreshing or teaching a specific skill; preparing learners emotionally through reflection and mental rehearsal; coaching on the approach, pace, and tone for a delivery that conveys empathy and meaning; and providing specific, honest, and curious feedback to close a performance gap. Additionally, the author acknowledges that clinical conditions sometimes require learning by observing rather than doing and has thus provided guidance for making the most of vicarious observational learning: identify potential challenges in the encounter and explicitly connect them to trainee learning goals, explain why a more advanced member of the team is conducting the conversation, ask the trainee to observe and prepare feedback, choose the location carefully, identify everyone's role at the beginning of the conversation, debrief, share reactions, and thank the trainee for their feedback and observations.

Sensory Processing Sensitivity and Compassion Satisfaction as Risk/Protective Factors from Burnout and Compassion Fatigue in Healthcare and Education Professionals.

The study analyzes sensory processing sensitivity and the compassion satisfaction as risk/protective factors against burnout and compassion fatigue, during the first period of the COVID-19 health emergency. A sample of 1566 Spanish adult healthcare (n = 694) and education (n = 872) professionals was evaluated. An ad hoc questionnaire for sociodemographic data, and the highly sensitive person scale (HSPS), Maslach burnout inventory (MBI) and professional quality of life scale (ProQOL-vIV) were administered. Burnout and compassion fatigue were observed in the healthcare and education professionals, where personal realization and depersonalization were higher in healthcare and compassion fatigue in education. The protective role of compassion satisfaction was confirmed, as was sensory processing sensitivity as a risk factor, except for its low sensory threshold dimension, which positively influenced personal realization. The findings of this study demonstrate the presence of burnout and compassion fatigue in healthcare and education professionals, displaying compassion fatigue as an emerging psychosocial risk in education, which was made more severe under the conditions of study, which is at the beginning of the COVID-19 pandemic. The importance of incorporating adequate management strategies for high sensitivity, empathy and compassion satisfaction in prevention programs is emphasized.

The Art of Surgery: Balancing Compassionate With Virtual Care.

The recent drive to include virtual care in surgical practice has been accelerated due to the COVID-19 pandemic. Many physicians feel that communicating via telehealth is unlike traditional methods of providing health care, and thus guidance on maintaining excellence in communication is necessary, especially as academic literature on virtual care in surgery is nonexistent. Challenges faced in transitioning to virtual care include the inability to utilize body language, barriers to traditional physical examination, exacerbation of existing vulnerabilities and inequities in patient groups, the declining quality of medical education, and the fragmentation of the multidisciplinary health care team. This paper seeks to resolve these challenges by focusing on the pillars of good communication, including preparation, professionalism, empathy, respect, and the virtual physical examination.