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Good communication is at the heart of excellent care for patients and families. At the Beth Israel Deaconess Medical Center Shapiro Institute for Education and Research, we have developed a communication training program for our internal medicine residents. During their intensive care unit (ICU) rotation, residents participate in weekly sessions to learn about key elements for compassionate, effective communication with family members of critically ill patients. The course focuses on teaching skills needed in initial meetings with families of critically ill patients such as answering family members' urgent questions, helping them understand and cope with the patient's illness, and responding to family members' distress, anger, or sadness. Residents are also taught how to sensitively lead family meetings later in the course of care, especially in discussing important decisions about goals of care when cure is unlikely and the patient's comfort and quality of life are paramount. Given the 3-week ICU rotation, the course is designed to be delivered in three parts over 4 hours: 1-hour sessions for the first 2 weeks and a 2-hour simulation session in the third week. Response rate for residents is 98% (n = 137). Residents are 54% male, 69% white, 20% Asian, 4% African American, and 7% other. Prior to training, 97% of residents felt that communication with family members was “very important”; however, few had any other communication training during residency, and many felt underprepared for carrying out important communication tasks. After the course, residents reported statistically significant improvements (p < .0001) in preparation to carry out all 17 surveyed skills, with moderate to high effect sizes (e.g., preparation to lead family meetings, 1-5 scale, 2.5-3.5; understanding of appropriate language to use in family communication, 2.5-3.4, p < .0001). Resident attitudes changed as well: Residents were more likely to agree that they wished they could lead more family meetings (pre vs. post: 15.4% vs. 69.3%), more comfortable talking to family about the possibility of death (30.1% vs. 84.6%), and less likely to agree that they dreaded having to deal with the emotional distress of family members of a patient at the end of life (53.8% vs. 23.1%).

This resource is a handbook designed to help individuals prepare for and conduct an effective teaching observation and feedback session. The handbook presents 10 steps that observers can follow to ensure they identify critical instructional moments during the teaching encounter and then engage in a mutual exchange of ideas with their colleagues at the conclusion of the session. It also suggests ways to avoid common peer observation pitfalls and describes the benefits of partaking in an observation pairing or buddy system. A number of references and sample peer observation of teaching forms are included at the end of the handbook. Creation of this resource originated from the need to translate the theory of peer observation into actual practice. While there have been recent calls from the Liaison Committee on Medical Education and the Accreditation Council for Graduate Medical Education for regularly scheduled feedback to medical education program faculty members about their clinical teaching abilities, there is little guidance on how that feedback should be collected and delivered. To provide individualized instructional development and feedback to the faculty members at our institution, we created the Peer Observation of Teaching Handbook for faculty members to follow in order to conduct effective teaching observations that would inform meaningful feedback to their peers. After each peer teaching observation, we send a brief feedback form to both the observer and the faculty member to collect comments and suggestions about the peer observation of teaching experience. Quantitative and qualitative feedback collected from the forms has been positive.