534 ADVANCED COMMUNICATION SKILLS: TEACHING DURING A PANDEMIC

Abstract Introduction In the first wave of the COVID-19 pandemic, it was recognised there would be an increased demand on clinicians to provide patients and relatives with bad news. The national ban on hospital visiting rapidly changed the way in which this news would be delivered. In recognition of these new challenges, our team sought to design a teaching course that could be implemented quickly and cost effectively, with the aim of improving clinician’s confidence around these difficult skills. Methods A teaching programme was created using senior geriatric and palliative care clinicians as simulated patients, open to any grade and speciality. Learners were required to break bad news (BBN) without any visual feedback, to simulate skills required when using the telephone. Surveys were collected to determine self–assessed confidence across four domains (Table 1) before, immediately after and 4–20 weeks after the course. Participants were asked to rank their confidence for each skill on a 5 point scale with 1 being very unsure and 5 being very confident. Results Pre-teaching scores showed an average of 3 (neither confident nor unsure) across all domains. After the course all domains improved, most notably around discussing end of life (EoL) care and discussing information over the phone. Conclusion This project has highlighted a lack of confidence across all skill levels when it comes to BBN. This confidence is easily improved by a short, cost-effective teaching course. It remains to be seen if this improved confidence translates to better communication with relatives.

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Development and preliminary evaluation of communication skills training program for oncologists based on patient preferences for communicating bad news

Palliative & Supportive Care ◽

10.1017/s147895151300031x ◽

2013 ◽

Vol 12 (5) ◽

pp. 379-386 ◽

Cited By ~ 25

Author(s):

Maiko Fujimori ◽

Yuki Shirai ◽

Mariko Asai ◽

Nobuya Akizuki ◽

Noriyuki Katsumata ◽

...

Keyword(s):

Communication Skills ◽

Emotional Support ◽

Patient Preferences ◽

Skills Training ◽

Bad News ◽

Simulated Patients ◽

Preliminary Evaluation ◽

Communication Skills Training ◽

Additional Information ◽

Didactic Lecture

AbstractObjective:The purposes of this study were to develop a communication skills training (CST) workshop program based on patient preferences, and to evaluate preliminary feasibility of the CST program on the objective performances of physicians and the subjective ratings of their confidence about the communication with patients at the pre- and post-CST.Methods:The CST program was developed, based on the previous surveys on patient preferences (setting up the supporting environment of the interview, making consideration for how to deliver bad news, discussing about additional information, and provision of reassurance and emotional support) and addressing the patient's emotion with empathic responses, and stressing the oncologists' emotional support. The program was participants' centered approach, consisted a didactic lecture, role plays with simulated patients, discussions and an ice-breaking; a total of 2-days. To evaluate feasibility of the newly developed CST program, oncologists who participated it were assessed their communication performances (behaviors and utterances) during simulated consultation at the pre- and post-CST. Participants also rated their confidence communicating with patients at the pre-, post-, and 3-months after CST, burnout at pre and 3 months after CST, and the helpfulness of the program at post-CST.Results:Sixteen oncologists attended a newly developed CST. A comparison of pre-post measures showed improvement of oncologists' communication performances, especially skills of emotional support and consideration for how to deliver information. Their confidence in communicating bad news was rated higher score at post-CST than at pre-CST and was persisted at 3-months after the CST. Emotional exhaustion scores decreased at 3-months after CST. In addition, oncologists rated high satisfaction with all components of the program.Significance of results:This pilot study suggests that the newly developed CST program based on patient preferences seemed feasible and potentially effective on improving oncologists' communication behaviors what patients prefer and confidence in communicating with patients.

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Teaching communication skills to radiology trainees: breaking bad news

Journal of Vascular and Interventional Radiology ◽

10.1016/j.jvir.2016.12.1067 ◽

2017 ◽

Vol 28 (2) ◽

pp. S190

Author(s):

J Meek ◽

K Carlson ◽

L Deloney ◽

M Meek

Keyword(s):

Communication Skills ◽

Bad News ◽

Breaking Bad News ◽

Breaking Bad

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Breaking Bad News — Skills and Evidence

InnovAiT Education and inspiration for general practice ◽

10.1093/innovait/inp133 ◽

2009 ◽

Vol 2 (10) ◽

pp. 605-612 ◽

Cited By ~ 1

Author(s):

Jill Thistlethwaite

Keyword(s):

Human Immunodeficiency Virus ◽

Communication Skills ◽

Human Immunodeficiency Virus Status ◽

Bad News ◽

Breaking Bad News ◽

Breaking Bad ◽

Immunodeficiency Virus ◽

The Future ◽

The Patient’S View ◽

The Impact

Bad or unfavorable news may be defined as ‘any news that drastically and negatively alters the patient's view of her or his future’( Buckman 1992 ). When GPs talk about breaking bad news, they usually mean telling patients that they have cancer, though in fact similar communication skills may be employed when informing patients about a positive human immunodeficiency virus status, or that a relative has died. Of key importance in the process is the doctor gaining an understanding of what the patient's view of the future is or was — the expectation that now might not be met. A doctor should not assume the impact of the diagnosis without exploring the patient's worldview.

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A realist evaluation exploring simulated patient role-play in pharmacist undergraduate communication training

BMC Medical Education ◽

10.1186/s12909-021-02776-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Aisling Kerr ◽

Judith Strawbridge ◽

Caroline Kelleher ◽

James Barlow ◽

Clare Sullivan ◽

...

Keyword(s):

Focus Groups ◽

Communication Skills ◽

Role Play ◽

Real Life ◽

Skills Training ◽

Realist Evaluation ◽

Communication Training ◽

Pharmacy Students ◽

Simulated Patients ◽

Rank Test

Abstract Background Effective communication between pharmacists and patients is essential and improves health outcomes. Simulated patients (SPs) are trained to reproduce real-life situations and can help pharmacy students to develop and adapt their communication skills in a safe, learner-centred environment. The aim of this research was to explore how SP and pharmacy student role-play supports communication training. Methods A mixed methods realist evaluation approach was adopted to test an initial theory relating to SP role-play for pharmacy students. The intervention tested involved complex communication cases in a men’s and women’s health module in year three of a new MPharm programme. This SP session was the first such session, of the programme which exclusively focused on complex communication skills for the students. Data collected comprised video-recordings of both training and mock OSCE sessions, and from student focus groups. Communication videos were scored using the Explanation and Planning Scale (EPSCALE) tool. Scores from SP and mock OSCE sessions were compared using the Wilcoxon-signed rank test. Focus groups were conducted with students about their experience of the training and analysed thematically, through a realist lens. Data was analysed for Context-Mechanism-Outcome configurations to produce modified programme theories. Results Forty-six students (n = 46/59, 78 %) consented to their video-recorded interactions to be used. Students identified contextual factors relating to the timing within the course and the setting of the intervention, the debrief and student individual contexts. Mechanisms included authenticity, feedback, reflection, self-awareness and confidence. Negative responses included embarrassment and nervousness. They distinguished outcomes including increased awareness of communication style, more structured communication and increased comfort. However quantitative data showed a decrease (p < 0.001) in communication scores in the mock OSCE compared with scores from training sessions. Modified programme theories relating to SP training for pharmacy students were generated. Conclusions SP role-play is a valuable communication skills training approach. Emphasis should be placed on multiple stakeholder feedback and promotion of reflection. Time limits need to be considered in this context and adjusted to meet student needs, especially for students with lower levels of communication comfort and those communicating in languages different to their first language.

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Dental students’ perceptions of learning communication skills in a forum theatre‐style teaching session on breaking bad news

European Journal Of Dental Education ◽

10.1111/eje.12407 ◽

2018 ◽

Vol 23 (2) ◽

pp. 95-100 ◽

Cited By ~ 2

Author(s):

Tarek Himida ◽

Sucharita Nanjappa ◽

Siyang Yuan ◽

Ruth Freeman

Keyword(s):

Communication Skills ◽

Dental Students ◽

Bad News ◽

Breaking Bad News ◽

Teaching Session ◽

Breaking Bad ◽

Forum Theatre

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A perspective on simulated patients’ and patient-educators’ teaching of communication skills

Medical Education ◽

10.1111/medu.13646 ◽

2018 ◽

Vol 52 (10) ◽

pp. 1097-1097 ◽

Cited By ~ 1

Author(s):

Mohammad Y Abdoolraheem ◽

Mohamad Zeina

Keyword(s):

Communication Skills ◽

Simulated Patients

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Teleoncology: Assessing online communication skills of millennial medical students.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.e13616 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. e13616-e13616

Author(s):

Ernesto Gil Deza ◽

Lourdes Gil Deza ◽

Mariana Abal ◽

Marta Dragosky ◽

Claudia Lorena Acuna ◽

...

Keyword(s):

Medical Students ◽

Communication Skills ◽

Communication Channel ◽

Student Assessment ◽

Online Communication ◽

Previous Experience ◽

Simulated Patients ◽

Alternative Communication ◽

Patient Understanding ◽

Network Connection

e13616 Background: COVID-19 posed new challenges in patient care and led to an increase in teleoncology. This paper analyzes telemedicine communication skills of millennial medical students of the postgraduate program of Clinical Oncology at Universidad del Salvador, Buenos Aires. Methods: Student assessment was based on a video call interaction with simulated patients in two stations (30 minutes each) of the Virtual Observational Standard Clinical Examination (V-OSCE), implemented in November 2020. Students received virtual communication guidelines and participated in training sessions to use the video call platform. All interactions were recorded. Assessment items (Table). Results: A total of 25 students were evaluated: 1 (4%) was ineligible due to network connection issues; 24 (96%) participated in both interactions. We analyzed 48 interactions in total. Opening: 6/48 interactions completed all five required items. Most recurring problems: not checking for patient’s previous experience with teleoncology (37/48) and not providing an alternative communication channel in case of technical difficulties (40/48). Middle: the results were similar to in-person interaction observed in previous exams, 35/48 interactions completed all required items. End: 16/48 interactions completed both items. In 32/48 the student did not check for patient understanding of the information provided. Only 3/48 interactions completed all 12 items. Conclusions: A) The V-OSCE is a useful tool to practice and evaluate teleoncology communication skills. B) The Middle Moment of the interactions was similar to an in-person interaction. However, the Opening and End of the interview were more challenging. The most critical struggles being: checking for patient’s previous experience in teleoncology, providing an alternative communication channel in case of technical difficulties and checking for patient understanding. C) COVID-19 established new forms of communication that are likely to remain even after the pandemic has ended. It is important to address this demand for online communication skills in medical education curricula.[Table: see text]

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Effects of electronic health record use on the exam room communication skills of resident physicians: a randomized within-subjects study

Journal of the American Medical Informatics Association ◽

10.1136/amiajnl-2014-002871 ◽

2014 ◽

Vol 22 (1) ◽

pp. 192-198 ◽

Cited By ~ 3

Author(s):

Teresa Taft ◽

Leslie Lenert ◽

Farrant Sakaguchi ◽

Gregory Stoddard ◽

Caroline Milne

Keyword(s):

Internal Medicine ◽

Communication Skills ◽

Simulated Patients ◽

First Year ◽

Laptop Computer ◽

Internal Medicine Training ◽

Paper Chart ◽

Within Subjects ◽

Electronic Health ◽

The Impact

Abstract Background The effects of electronic health records (EHRs) on doctor–patient communication are unclear. Objective To evaluate the effects of EHR use compared with paper chart use, on novice physicians’ communication skills. Design Within-subjects randomized controlled trial using observed structured clinical examination methods to assess the impact of use of an EHR on communication. Setting A large academic internal medicine training program. Population First-year internal medicine residents. Intervention Residents interviewed, diagnosed, and initiated treatment of simulated patients using a paper chart or an EHR on a laptop computer. Video recordings of interviews were rated by three trained observers using the Four Habits scale. Results Thirty-two residents completed the study and had data available for review (61.5% of those enrolled in the residency program). In most skill areas in the Four Habits model, residents performed at least as well using the EHR and were statistically better in six of 23 skills areas (p<0.05). The overall average communication score was better when using an EHR: mean difference 0.254 (95% CI 0.05 to 0.45), p = 0.012, Cohen's d of 0.47 (a moderate effect). Residents scoring poorly (>3 average score) with paper methods (n = 8) had clinically important improvement when using the EHR. Limitations This study was conducted in first-year residents in a training environment using simulated patients at a single institution. Conclusions Use of an EHR on a laptop computer appears to improve the ability of first-year residents to communicate with patients relative to using a paper chart.

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