Surgeons' attitudes about communicating with patients and their families.

CONTEXT: Surgeons face difficult communication challenges with patients and their families. There is a need for improved education in communication skills, especially in giving bad news. Understanding surgeons' attitudes is the first step in designing effective education programs.

OBJECTIVE: To determine surgeons' self-assessment of competence, rating of importance, and perceived need for training in communication skills relevant to patient care.

DESIGN: Anonymous self-report mail survey of demographic information and attitudes toward 12 patient care-related communication skills.

SETTING: San Diego County, California, a geographically distinct area of close to 3 million inhabitants receiving health care from over 6000 physicians.

PARTICIPANTS: A total of 351 (43.4%) respondents from the 833 surgical specialists in the San Diego County Medical Society list of member and nonmember physicians.

MAIN OUTCOME MEASURES: Measurement of surgeons' attitudes toward self-perceived competence, importance, need for training in the communication skills, and the influence of age, duration of practice, and surgical-specialty on attitudes.

RESULTS: Most respondents rated their competence high except in 3 skills relating to a patient's death. They found all skills important and indicated a need for training in them. Younger surgeons rated their competence and the importance significantly lower in the 3 skills relating to a patient's death (p < 0.05). Critical care surgical specialists rated their competence and the importance higher in skills relating to breaking bad news and a patient's death than did the non-critical care group (p < 0.05). Older surgeons and critical care specialists also indicated a higher level of support for training in these skills.

CONCLUSION: These results suggest that surgical specialists rate themselves as competent in effective communication, believe in its importance, and agree with the need for training. An organized approach to training in interaction skills, especially in giving bad news, is warranted.