scholarly journals Improving Oncology Nurses' Communication Skills for Difficult Conversations

2013 ◽  
Vol 17 (3) ◽  
pp. E45-E51 ◽  
Author(s):  
Linda Baer ◽  
Elizabeth Weinstein
Author(s):  
Lidia Borghi ◽  
Elaine C. Meyer ◽  
Elena Vegni ◽  
Roberta Oteri ◽  
Paolo Almagioni ◽  
...  

To describe the experience of the Italian Program to Enhance Relations and Communication Skills (PERCS-Italy) for difficult healthcare conversations. PERCS-Italy has been offered in two different hospitals in Milan since 2008. Each workshop lasts 5 h, enrolls 10–15 interdisciplinary participants, and is organized around simulations and debriefing of two difficult conversations. Before and after the workshops, participants rate their preparation, communication, relational skills, confidence, and anxiety on 5-point Likert scales. Usefulness, quality, and recommendation of the program are also assessed. Descriptive statistics, t-tests, repeated-measures ANOVA, and Chi-square were performed. A total of 72 workshops have been offered, involving 830 interdisciplinary participants. Participants reported improvements in all the dimensions (p < 0.001) without differences across the two hospitals. Nurses and other professionals reported a greater improvement in preparation, communication skills, and confidence, compared to physicians and psychosocial professionals. Usefulness, quality, and recommendation of PERCS programs were highly rated, without differences by discipline. PERCS-Italy proved to be adaptable to different hospital settings, public and private. After the workshops, clinicians reported improvements in self-reported competencies when facing difficult conversations. PERCS-Italy’s sustainability is based on the flexible format combined with a solid learner-centered approach. Future directions include implementation of booster sessions to maintain learning and the assessment of behavioral changes.


2014 ◽  
Vol 11 (8) ◽  
pp. 781-787 ◽  
Author(s):  
Stephen D. Brown ◽  
Michael J. Callahan ◽  
David M. Browning ◽  
Robert L. Lebowitz ◽  
Sigall K. Bell ◽  
...  

Neurology ◽  
2018 ◽  
Vol 90 (2) ◽  
pp. 93-97 ◽  
Author(s):  
Monica E. Lemmon ◽  
Charlene Gamaldo ◽  
Rachel Marie E. Salas ◽  
Ankita Saxena ◽  
Tiana E. Cruz ◽  
...  

ObjectiveTo characterize features of medical student exposure to difficult conversations during a neurology core clerkship.MethodsThis was a cross-sectional concurrent nested mixed methods study, and all students rotating through a required neurology clerkship between 2014 and 2015 were enrolled. Data collection included an electronic communication tracker, baseline and end-of-clerkship surveys, and 4 facilitated focus groups. Students were asked to log exposure to patient–clinician conversations about (1) new disability, (2) poor prognosis, (3) prognostic uncertainty (4), terminal diagnosis, and (5) end-of-life care.ResultsA total of 159 students were enrolled and 276 conversations were tracked. Most (70%) students observed at least 1 difficult conversation, and conversations about poor prognosis, new disability, and prognostic uncertainty were most commonly logged. At clerkship end, most students (87%) desired additional bedside training in communication skills. Exposure to one of the predefined conversation types did not improve student perceived preparedness to lead difficult conversations in the future. In focus groups, students noted that the educational value of observation of a difficult conversation could be optimized with preconversation planning and postconversation debriefing.ConclusionsDifficult conversations are common in neurology, and represent a valuable opportunity to provide communication skills training on the wards. Future curricula should consider ways to leverage these existing opportunities to enhance communication skills training.


2018 ◽  
Vol 36 (34_suppl) ◽  
pp. 9-9 ◽  
Author(s):  
Leslie J. Hinyard ◽  
Cara L Wallace ◽  
Jennifer E Ohs ◽  
April Trees

9 Background: Increasingly, Narrative Medicine (NM) is utilized in clinical experiences. Critical reflection is a core aspect of NM providing the narrative competence to “recognize, absorb, interpret, and honor” the stories of self and other. This study evaluates the effectiveness of a NM workshop to: 1) develop skills in attending and responding to the stories of others as a part of advance care planning (ACP) conversations and 2) reflect on their own stories of loss in relation to professional practice. Developing narrative skills may help overcome barriers to successful ACP with patients and families. Methods: 29 health care professionals completed a continuing education course on NM principles for end-of-life care. Workshop activities included a close reading on a professional’s story of personal loss and a reflective writing exercise sharing one’s own personal story of loss. Small groups debriefed after each exercise. 24 participants (83%) completed post-workshop surveys including closed and open-ended questions. Results: Mean age of participants was 50.3 (SD 14.7), 87% were female, and 92% White. Social workers represented 71% of the sample with clinicians across several specialty areas. Findings indicate 80% of participants strongly agreed the experience of writing about their own experiences of loss helped develop their communication skills and 88% strongly agreed the experience of listening to stories of others helped develop their communication skills and they would use skills from the workshop in practice. Common themes from qualitative analysis included the usefulness of techniques for framing difficult conversations, patient vulnerability, the importance of active listening, and increased empathy for the storyteller. Common themes reflecting on providers’ personal stories of loss included recognition of prior experience on professional interactions and reported improved skills in authentic interactions and increased capacity for empathy. Conclusions: NM competencies have the potential to enhance communication surrounding ACP. Providers find the NM approach to be a useful framework for engaging in difficult conversations about end-of-life.


2010 ◽  
Vol 66 (10) ◽  
pp. 2266-2277 ◽  
Author(s):  
Wolf Langewitz ◽  
Lukas Heydrich ◽  
Matthias Nübling ◽  
Linda Szirt ◽  
Heidemarie Weber ◽  
...  

2021 ◽  
Vol 18 (3) ◽  
Author(s):  
Mahdieh  Poodineh Moghadam ◽  
Ahmad Nasiri ◽  
Gholamhossein Mahmoudirad

Background: Establishing appropriate communication with cancer patients is necessary to make decisions for them and involve them in the care process to prevent the adverse consequences of cancer treatment. Thus, the qualitative study on the challenges experienced by oncology nurses can lead to a better understanding of these challenges and help these nurses acquire advanced communication skills. Objectives: This study was conducted to explain the communication challenges experienced by oncology nurses during providing care to cancer patients by applying a qualitative content analysis approach. Methods: This qualitative study was conducted with the participation of 18 nurses who were selected by the purposive sampling method, working in the oncology departments of Iran’s hospitals in 2021. Semi-structured interviews were held for data collection. After transcribing the interviews, data analysis was performed using the Granheim and Landman (2004) method. The MAXQDA software (2020) was used for data management. The criteria proposed by Lincoln and Guba were used to assure data accuracy and reliability. Results: Thirty subcategories, eight categories, and four themes were extracted following data analysis. The themes included the nurse’s close relationship with cancer patients as a double-edged sword, curvy and sinusoidal professional communication for oncology nurses, relationship with an opposite-gender patient as a missing factor in nursing care, and marginalization of relationships during the coronavirus pandemic. Conclusions: Nurses’ challenges in communicating with cancer patients can be reduced by improving their communication skills via various strategies, including empowering nurses by employing cognitive empathy and using communication models such as the Comfort model.


2015 ◽  
Vol 19 (6) ◽  
pp. 697-702 ◽  
Author(s):  
Nessa Coyle ◽  
Ruth Manna ◽  
Megan Shen ◽  
Smita Banerjee ◽  
Stacey Penn ◽  
...  

2021 ◽  
Vol 50 (Supplement_1) ◽  
pp. i12-i42
Author(s):  
B Pyrke ◽  
B Abdalla ◽  
G Cartwright ◽  
K Figg ◽  
E Murphy ◽  
...  

Abstract Introduction As junior doctors, we very rarely receive formal teaching on communication after medical school, with telephone encounters and difficult conversations over technology being a vital yet missing part of our education. The COVID-19 pandemic has required us to adapt how we communicate with patients’ families due to hospital visiting restrictions. In an era where tragically deterioration and death have been much more commonplace, we looked to identify areas where junior doctors felt their communication skills could be improved, and implemented a teaching programme to deliver this. Methods Pre-teaching questionnaires were distributed to a range of grades of junior doctors working in University Hospital of Llandough, Cardiff. The questionnaires were distributed at the beginning of June 2020, after 3 months of working in pandemic conditions. A teaching session on telephone and video communication skills was delivered by a local palliative care consultant. Post-teaching, a repeat questionnaire was undertaken to assess response and identify key learning points. Results Pre-teaching, 100% of the 22 respondents had had to participate in difficult conversations over the phone, 82% had had no formal phone based communication skills training and 81.82% felt some form of formal teaching would be helpful. Post-teaching, 12 junior doctors provided feedback with an average 37% increase in confidence to undertake difficult conversations. Key learning points from the session highlighted the importance of preparation, regularly updating the family to build trust and rapport, and integrating family updates via tele-communication into daily ward life. Conclusions Education around telephone communication skills is critical to enable us to adapt our skills in accordance with the demands of the pandemic, to continue to support relatives and to engage with technology with confidence. Increased preparation is required to navigate difficult conversations via technology, and successful communication requires clinicians to take responsibility for initiating regular family updates.


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