Improving Serious Illness Communication : Testing the Serious Illness Care Program with Trainees
(2022) In Journal of Pain and Symptom Management 63(2). p.252-259- Abstract
Background: Early conversations about patients’ goals and values improve care, but clinicians struggle to conduct them. The systems-based Serious Illness Care Program (SICP) helps clinicians have more, better, and earlier conversations. Central to this approach is a clinician conversation guide for patient encounters. While the SICP works for practicing clinicians, it has not been tested with medical trainees. Intervention: We adapted the SICP training to emphasize assessing prognostic awareness and responding to emotion. We developed a 2.5-hour SICP workshop for medical students and medical interns that included large- and small-group work, practice with an actor, and interdisciplinary clinician facilitators. We trained 81 students and... (More)
Background: Early conversations about patients’ goals and values improve care, but clinicians struggle to conduct them. The systems-based Serious Illness Care Program (SICP) helps clinicians have more, better, and earlier conversations. Central to this approach is a clinician conversation guide for patient encounters. While the SICP works for practicing clinicians, it has not been tested with medical trainees. Intervention: We adapted the SICP training to emphasize assessing prognostic awareness and responding to emotion. We developed a 2.5-hour SICP workshop for medical students and medical interns that included large- and small-group work, practice with an actor, and interdisciplinary clinician facilitators. We trained 81 students and 156 interns and obtained anonymous quantitative and qualitative feedback. Outcomes: Eighty-six percent of students and 91% of residents rated the session as “very good” or “excellent” and >90% of all learners would either recommend this training or intended to apply this to their practice. Post-session learner confidence increased in all communication skills. Learners said the training provided a helpful framework and useful language for these conversations. Resident documentation of serious illness conversations in the medical record increased dramatically during the year following training commencement. Conclusions: Grounded in principles of adult learning theory, this training was rated highly by trainees and resulted in demonstrable practice change. These early learners were more flexible and willing to try this approach than practicing clinicians who tend to resist or revert to old habits. A Guide represents a new paradigm for teaching communication skills and is valued by early learners.
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- author
- Zehm, April ; Scott, Erin ; Schaefer, Kristen G. ; Nguyen, Phuong L. and Jacobsen, Juliet LU
- publishing date
- 2022-02
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- advance care planning, Communication, goals of care, medical education, palliative care, serious illness conversations
- in
- Journal of Pain and Symptom Management
- volume
- 63
- issue
- 2
- pages
- 252 - 259
- publisher
- Elsevier
- external identifiers
-
- scopus:85120704459
- pmid:34743012
- ISSN
- 0885-3924
- DOI
- 10.1016/j.jpainsymman.2021.10.013
- language
- English
- LU publication?
- no
- additional info
- Funding Information: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. None of the authors have any disclosures to report. Publisher Copyright: © 2021 American Academy of Hospice and Palliative Medicine
- id
- 41d91c9e-83c9-4b44-ab21-a317ffbad2fb
- date added to LUP
- 2023-04-18 11:19:42
- date last changed
- 2024-11-16 18:53:49
@article{41d91c9e-83c9-4b44-ab21-a317ffbad2fb,
abstract = {{<p>Background: Early conversations about patients’ goals and values improve care, but clinicians struggle to conduct them. The systems-based Serious Illness Care Program (SICP) helps clinicians have more, better, and earlier conversations. Central to this approach is a clinician conversation guide for patient encounters. While the SICP works for practicing clinicians, it has not been tested with medical trainees. Intervention: We adapted the SICP training to emphasize assessing prognostic awareness and responding to emotion. We developed a 2.5-hour SICP workshop for medical students and medical interns that included large- and small-group work, practice with an actor, and interdisciplinary clinician facilitators. We trained 81 students and 156 interns and obtained anonymous quantitative and qualitative feedback. Outcomes: Eighty-six percent of students and 91% of residents rated the session as “very good” or “excellent” and >90% of all learners would either recommend this training or intended to apply this to their practice. Post-session learner confidence increased in all communication skills. Learners said the training provided a helpful framework and useful language for these conversations. Resident documentation of serious illness conversations in the medical record increased dramatically during the year following training commencement. Conclusions: Grounded in principles of adult learning theory, this training was rated highly by trainees and resulted in demonstrable practice change. These early learners were more flexible and willing to try this approach than practicing clinicians who tend to resist or revert to old habits. A Guide represents a new paradigm for teaching communication skills and is valued by early learners.</p>}},
author = {{Zehm, April and Scott, Erin and Schaefer, Kristen G. and Nguyen, Phuong L. and Jacobsen, Juliet}},
issn = {{0885-3924}},
keywords = {{advance care planning; Communication; goals of care; medical education; palliative care; serious illness conversations}},
language = {{eng}},
number = {{2}},
pages = {{252--259}},
publisher = {{Elsevier}},
series = {{Journal of Pain and Symptom Management}},
title = {{Improving Serious Illness Communication : Testing the Serious Illness Care Program with Trainees}},
url = {{http://dx.doi.org/10.1016/j.jpainsymman.2021.10.013}},
doi = {{10.1016/j.jpainsymman.2021.10.013}},
volume = {{63}},
year = {{2022}},
}