Presented By: Chris Gitter, Medical College of Wisconsin
Co-Authors: Himanshu Agrawal, Medical College of Wisconsin
Jose Lucas Zepeda, Medical College of Wisconsin
Madeline McGauley, Medical College of Wisconsin
Omeed Partovi, Medical College of Wisconsin
Andrew Petroll, Medical College of Wisconsin
Molly Thapar, Medical College of Wisconsin
April Zehm, Medical College of Wisconsin

Purpose 
Communication skills training (CST) remains undervalued and underrepresented within undergraduate medical curricula, especially at the preclinical level. Students transitioning to clinical rotations may lack confidence and feel unprepared for challenging patient conversations. Operation Conversation (OC) is a novel student-run extracurricular, mentored CST program for preclinical medical students to practice difficult conversations. We developed and piloted a longitudinal, extracurricular CST program focused on challenging and underrepresented content areas prior to clerkships. 

Methods 
OC involved three, 90-minute virtual workshops for preclinical students. During each workshop, students reviewed a case and relevant medical content, then role-played in pairs while a facilitator observed. All parties completed a communication skills checklist, students received verbal feedback, then roles reversed. Self-, peer-, and facilitator-completed communication skills checklists were completed after each role play, enabling individual, longitudinal communication skill tracking over time. Students' open-ended reflections on the experience were analyzed for themes, and final program evaluations were collected. 

Results 
Sixty-four students participated in OC during the first year of implementation. Mean communication scores increased from the first to the third workshop as rated by self (75.2% to 86.7%, P<0.05), peers (87.8% to 93.6%, P<0.05), and facilitators (82.9% to 92.6%, P<0.05). Students valued the challenging experiential learning despite initial anxiety, getting feedback, and the perspective-taking gained by playing both roles. 

Conclusions
Program strengths include student-driven learning, a 2:1 student-to-facilitator ratio, formative real-time feedback, and longitudinal tracking of communication skill development over time. The program was extracurricular with voluntary participation, which limits impact and implications. The program has entered its third year. Simple workshop materials and the virtual format make this feasible and transferable. While it may be difficult to maintain our learner-to-facilitator ratio for larger, class-wide activities, the role-play, communication checklist, and feedback activities could be adapted for use in the core curriculum.