Evaluation of a novel individualised communication-skills training intervention to improve doctors' confidence and skills in end-of-life communication.
BACKGROUND
We developed a novel individualised training program regarding end-of-life communication, designed to be time effective for busy junior-doctors working in hospital settings.


OBJECTIVE
We aimed to pilot this brief individualised training program with junior-doctors to explore its acceptability, feasibility and effect on the doctors' confidence, communication skills, attitudes towards psychosocial care and burnout.


METHODS
The content of the training intervention was informed by a systematic literature review and evidence-based clinical practice guidelines regarding end-of-life communication. The intervention was based on sound educational principles and involved three one-hour teaching sessions over a three-week period, including two individual sessions with an expert facilitator and simulated patient/caregiver. In addition, participants received written and audiovisual take-home learning materials. PARTICIPANTS were videotaped consulting with a simulated patient/caregiver pre/post training to assess the impact of the course on their communication behaviours. PARTICIPANTS completed de-identified questionnaires pre/post training, including self-assessed confidence, attitudes to psychosocial care, and the Maslach Burnout inventory.


METHODS
PARTICIPANTS included 22 junior-doctors from a large teaching hospital in Sydney, Australia.


RESULTS
All participants reported that the training was useful, had been helpful for their communication with patients and that they would recommend the training to others. Significant improvements were found in participants' communication skills (in seven out of 21 specific and all three global communication behaviours assessed, range P=0.02 to <0.001), confidence in communicating about relevant topics (P<0.001), attitudes towards psychosocial care (P=0.03) and sense of personal accomplishment (P=0.043). There were no overall differences in participants' burnout levels.


CONCLUSIONS
This intervention shows promise and warrants further formal evaluation.
Centre for Medical Psychology and Evidence-based Decision Making, University of Sydney, Australia. josephine.clayton@sydney.edu.au
Josephine M
JM
Clayton
Phyllis N
PN
Butow
Amy
A
Waters
Rebekah C
RC
Laidsaar-Powell
Angela
A
O'Brien
Frances
F
Boyle
Anthony L
AL
Back
Robert M
RM
Arnold
James A
JA
Tulsky
Martin H N
MH
Tattersall
D000328:Adult; D002055:Burnout, Professional; D003142:Communication; D003258:Consumer Behavior; D004503:Education, Medical, Graduate / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations; D010865:Pilot Projects; D011361:Professional Competence; D020377:Self Efficacy; D013727:Terminal Care; D055815:Young Adult