title: [Between science and suffering: difficult conversations in healthcare].
abstract: BACKGROUND
  This article describes the adaptation and implementation of the Program to Enhance Relational and Communication Skills (PERCS) in Italy. PERCS was originally developed at Children's Hospital Boston and aims to enhance clinicians' preparedness to engage in difficult conversations with patients/families.
  
  
  METHODS
  After a period of collaboration by the first author with the Children's Hospital Boston, PERCS was launched at San Paolo Hospital, Milan, in 2008. To date, over 80 participants have voluntarily attended the program. The program features monthly 4-hour workshops geared around the enactment of a case scenario by trained actors and participants. Each workshop enrolls 10-13 interdisciplinary participants. After each enactment, participants receive feedback by actors, other participants and facilitators on the challenging junctures of the conversation. Pedagogical principles include: creating safety for learning; emphasizing moral and relational dimensions of care; suspending hierarchy among participants; valuing self-reflection; honoring multiple perspectives; and offering continuity of the educational offering.
  
  
  CONCLUSIONS
  Implementing PERCS in Italy has demonstrated that it is possible to culturally adapt learning opportunities that embrace the relational and ethical experience of learners. The positive response of participants affirms that relational learning is meaningful and needed.
authors.affiliation: Centro CURA, Ospedale San Paolo, Università, Milano. giulia.lamiani@unimi.it
authors.forename: Giulia
authors.initials: G
authors.lastname: Lamiani
authors.forename: Elaine C
authors.initials: EC
authors.lastname: Meyer
authors.forename: David M
authors.initials: DM
authors.lastname: Browning
authors.forename: Egidio A
authors.initials: EA
authors.lastname: Moja
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002648:Child; D003142:Communication; D004502:Education, Medical, Continuing / Q000379:methods*; D004644:Emotions; D004992:Ethics, Medical / Q000193:education; D030141:Feedback, Psychological; D006785:Hospitals, University; D006801:Humans; D033183:Interdisciplinary Communication; D007558:Italy; D016544:Patient Simulation; D010372:Pediatrics / Q000193:education*; D010817:Physician-Patient Relations / Q000941:ethics; D011368:Professional-Family Relations / Q000941:ethics; D015397:Program Evaluation; D013315:Stress, Psychological; D014342:Truth Disclosure / Q000941:ethics