title: Cross-cultural adaptation of an innovative approach to learning about difficult conversations in healthcare.
abstract: BACKGROUND
  The Program to Enhance Relational and Communication Skills (PERCS) was developed at a large hospital in the United States to enhance clinicians' preparedness to engage in difficult conversations.
  
  
  OBJECTIVE
  To describe the implementation of PERCS in an Italian hospital and assess the program's efficacy.
  
  
  METHODS
  The Italian PERCS program featured 4-h experiential workshops enrolling 10-15 interdisciplinary participants. The workshops were organized around the enactment and debriefing of realistic case scenarios portrayed by actors and volunteer clinicians. Before and after the workshop, participants rated their perceived preparation, communication and relational skills, confidence, and anxiety on 5-point Likert scales. Open-ended questions explored their reflections on the learning. T-tests and content analysis were used to analyze the quantitative and qualitative data, respectively.
  
  
  RESULTS
  146 clinicians attended 13 workshops. Participants reported better preparation, confidence, and communication skills (p < 0.001) after the workshops. The program had a different impact depending on the discipline. Participants valued the emphasis on group feedback, experiential and interdisciplinary learning, and the patient's perspective, and acquired: new communication skills, self-reflective attitude, reframed perspective, and interdisciplinary teamwork.
  
  
  CONCLUSIONS
  PERCS proved culturally adaptable to the Italian context and effective in improving participants' sense of preparation, communication skills, and confidence.
authors.affiliation: Universita' degli Studi di Milano, Italy. 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: Daniela
authors.initials: D
authors.lastname: Leone
authors.forename: Elena
authors.initials: E
authors.lastname: Vegni
authors.forename: David M
authors.initials: DM
authors.lastname: Browning
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Rider
authors.forename: Robert D
authors.initials: RD
authors.lastname: Truog
authors.forename: Egidio A
authors.initials: EA
authors.lastname: Moja
mesh_terms: D000328:Adult; D003142:Communication; D003469:Culture; D005260:Female; D006282:Health Personnel; D006801:Humans; D007400:Interprofessional Relations; D007558:Italy; D008297:Male; D008875:Middle Aged; D011369:Professional-Patient Relations; D013192:Staff Development / Q000458:organization & administration*; D014481:United States