title: [Difficult conversations in nephrology: assessment of a formative experience].
abstract: BACKGROUND
  Nephrologists often have to discuss difficult news with patients such as discussing treatment and prognosis, forgoing dialysis or end-of-life. Despite this, there are few educational interventions in this field. The aim of this study is to assess the efficacy of a workshop on difficult conversations in dialysis.
  
  
  METHODS
  Within the Program to Enhance Relational and Communication Skills (PERCS) we developed a 4-hour workshop focused on communication in dialysis (PERCS-dialysis) at San Paolo Hospital,Milan. The workshop is geared around the enactment and debriefing of a case scenario. The scenario involves three conversations with a patient and a family member on dialysis and transplant. Before and after the workshop, participants are asked to complete a questionnaire on: sense of preparation, communication skills, relational skills, confidence and anxiety. The post-questionnaire also included some open-ended questions on the learning experience.
  
  
  RESULTS
  81 clinicians participated to 8 workshops. After the workshop, participants reported better preparation (p=.000) and confidence (p=.000). Perceived communication skills (p=.060), relational skills (p=.438) and anxiety (p=.441) improved but not significantly. All participants (100%) would recommend the workshop. In the open-ended questions participants reflected on the learning, appreciated the interactive methodology and offered suggestions.
  
  
  CONCLUSIONS
  Consistently with the educational objectives, clinicians improved their preparedness and confidence in holding difficult conversations. Clinicians perception of their communication and relational abilities did not change. To affect these skills a longer and more intensive training is probably needed.
authors.forename: Giulia
authors.initials: G
authors.lastname: Lamiani
authors.forename: Maurizio
authors.initials: M
authors.lastname: Gallieni
authors.forename: Irene
authors.initials: I
authors.lastname: Strada
authors.forename: Elena
authors.initials: E
authors.lastname: Vegni
mesh_terms: D000488:Allied Health Personnel; D003142:Communication; D004493:Education; D004502:Education, Medical, Continuing; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007558:Italy; D007676:Kidney Failure, Chronic / Q000628:therapy*; D016030:Kidney Transplantation / Q000379:methods; D008297:Male; D008875:Middle Aged; D009398:Nephrology; D009723:Nurse-Patient Relations; D009726:Nurses; D010817:Physician-Patient Relations; D010820:Physicians; D006435:Renal Dialysis / Q000379:methods; D011795:Surveys and Questionnaires