Radiology Trainees’ Comfort With Difficult Conversations and Attitudes About Error Disclosure: Effect of a Communication Skills Workshop Stephen D. Brown, MD a,b , Michael J. Callahan, MD a , David M. Browning, MSW c , Robert L. Lebowitz, MD a , Sigall K. Bell, MD b,d , Jisun Jang, MA e , Elaine C. Meyer, RN, PhD a,f Purpose: The aim of this study was to assess the effect of communication skills training on radiology trainees’ (1) comfort with communicating directly with patients and family members about unexpected or difficult diagnoses (“bad news”), radiologic errors, and radiation risks and (2) attitudes about disclosing radiologic errors directly to patients and their families. Methods: One hundred nine radiology trainees from 16 US programs were asked to complete questionnaires immediately before and after attending an institutional review boardeexempted, full-day communication workshop. Questionnaires assessed (1) comfort communicating with patients and their families generally and about bad news, radiologic errors, and radiation risks specifically; (2) attitudes and behavioral intent regarding a hypothetical vignette involving a radiologic error; and (3) desire for additional communication training. Results: All trainees completed the questionnaires. After completing the workshop, more trainees reported comfort communicating with patients about bad news, errors, and radiation risks (pre vs post, 44% vs 73%, 25% vs 44%, and 34% vs 58%, respectively, P < .001 for all). More also agreed that the radiologist in the error vignette should discuss the error with the patient (pre vs post, 84% vs 95%; P ¼ .002) and apologize (pre vs post, 78% vs 94%; P < .001). After participation, fewer trainees reported unwillingness to disclose the error despite medicolegal concerns (pre vs post, 39 vs 15%; P < .001). Despite high baseline comfort (92%) and low stress (14%) talking with patients in general, most respondents after participation desired additional communication training on error disclosure (83%), general communication (56%), and radiation risks (80%). Conclusions: This program provides effective communication training for radiology trainees. Many trainees desire more such programs. Key Words: Communication, professionalism, diagnostic errors, education, radiology J Am Coll Radiol 2014;11:781-787. Copyright © 2014 American College of Radiology INTRODUCTION Radiologists face mounting expectations to communicate directly with patients. Such expectations are driven by evolving radiologic practices, cultural changes within medicine, technological advances, medicolegal exigencies, and revised understandings of radiologists’ professional roles [1-6]. Radiologists’ accountability to patient-centered and value-based care is being asserted by major professional organizations, such as the ACR and the RSNA [7,8]. Such accountability includes ensuring that patients receive timely and clear diagnostic information [1,2,4-6], discus- sing radiologic errors with patients directly and honestly [9-12], and communicating effectively about radiation exposure [13,14]. The Diagnostic Radiology Milestones a Department of Radiology, Boston Children’s Hospital and Harvard Medical School, Boston, Massachusetts. b Institute for Professionalism and Ethical Practice, Boston Children’s Hos- pital, Boston, Massachusetts. c Department of Social Work, Massachusetts General Hospital, Boston, Massachusetts. d Department of Medicine, Beth Israel Deaconess Medical Center and Har- vard Medical School, Boston, Massachusetts. e Clinical Research Center, Boston Children’s Hospital, Boston, Massachusetts. f Department of Psychiatry, Harvard Medical School, Boston, Massachusetts. Corresponding author and reprint requests: Stephen D. Brown, MD, Children’s Hospital Boston, Department of Radiology, 300 Longwood Avenue, Boston, MA 02115; e-mail: stephen.brown@childrens.harvard.edu. Funding for this program was provided by a 2011 RSNA Education Scholar Grant. Pilot funding for this program was provided by the Boston Children’s Hospital Radiology Foundation. ª 2014 American College of Radiology 781 1546-1440/14/$36.00  http://dx.doi.org/10.1016/j.jacr.2014.01.018