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Motivating physicians to attend and actively engage in communication skills training is often perceived as an enormous feat. We knew if we put a program in front of experienced clinicians, it had to be rock solid. In addition, we wanted to provide participants with an experience equivalent to, if not exceeding, that of a patient. This strategy entailed modeling the skills we teach with one another and with participants in an authentic and meaningful way, recognizing their expertise and valuing their contributions.

Basic Principles of Engagement

We were mindful of Maslow's hierarchy of needs in creating a climate conducive to learning. Maslow proposed that certain needs (biological/physiological, safety, belongingness/love, and esteem) be met in order to reach self-actualization or a state of personal growth and fulfillment.1 We considered many of Maslow's hierarchy of needs to be absolute prerequisites for an optimal learning environment. Before participants attended the course, they received a detailed e-mail outlining the course, the location, where to park, the number of breaks, meals, and even suggesting a comfortable, layered type of dress to accommodate fluctuating temperatures. If participants had specific requests, such as dietary needs, they were invited to contact our program manager who addressed each and every request. Upon arrival, participants were greeted warmly with a smile and handshake. Rather than rushing into the course content, participants were invited to hang up their coats, get comfortable, and have breakfast.

We also thought about the size of the group and how this would impact learning, safety, connection, and active participation.2 Groups were maxed at 12 with two facilitators and divided into two smaller groups for skills practice. Groups larger than this can make it easy for some participants to fade into the background, allowing others to dominate the conversation and focus the learning in personal areas of interest that might not be the consensus of the group at large.

To foster a sense of connection and belonging, facilitators were mindful to connect with participants and/or connect participants with each other in a personal manner. Each of these steps was also included to convey value and respect, an important ingredient in establishing a personal relationship and a relationship as part of the group.3 For those of us facilitating, it was really important to provide colleagues who are hardworking experts in their fields, working under incredible time and task pressure, with an experience that rejuvenated the clinician while improving patient care.

As with any educational intervention, designing a curriculum that can meet all learners "where they are" is a rigorous and critical process. I will highlight the core principles and methods that have made communication skills training effective for our experienced, and sometimes reluctant, learners. Of course, we could not learn what strategies worked without also stumbling upon a few that did not.

Creating Solid Curriculum ...

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