title: Interprofessional communication skills training for serious illness: evaluation of a small-group, simulated patient intervention.
abstract: BACKGROUND
  Communication with patients and families is an essential component of high-quality care in serious illness. Small-group skills training can result in new communication behaviors, but past studies have used facilitators with extensive experience, raising concerns this is not scalable.
  
  
  OBJECTIVE
  The objective was to investigate the effect of an experiential communication skills building workshop (Codetalk), led by newly trained facilitators, on internal medicine trainees' and nurse practitioner students' ability to communicate bad news and express empathy.
  
  
  METHODS
  Trainees participated in Codetalk; skill improvement was evaluated through pre- and post- standardized patient (SP) encounters.
  
  
  METHODS
  The subjects were internal medicine residents and nurse practitioner students at two universities.
  
  
  METHODS
  The study was carried out in anywhere from five to eight half-day sessions over a month. The first and last sessions included audiotaped trainee SP encounters coded for effective communication behaviors. The primary outcome was change in communication scores from pre-intervention to post-intervention. We also measured trainee characteristics to identify predictors of performance and change in performance over time.
  
  
  RESULTS
  We enrolled 145 trainees who completed pre- and post-intervention SP interviews-with participation rates of 52% for physicians and 14% for nurse practitioners. Trainees' scores improved in 8 of 11 coded behaviors (p<0.05). The only significant predictors of performance were having participated in the intervention (p<0.001) and study site (p<0.003). The only predictor of improvement in performance over time was participating in the intervention (p<0.001).
  
  
  CONCLUSIONS
  A communication skills intervention using newly trained facilitators was associated with improvement in trainees' skills in giving bad news and expressing empathy. Improvement in communication skills did not vary by trainee characteristics.
authors.affiliation: 1 Department of Medicine, University of Washington , Seattle, Washington.
authors.forename: Alison M
authors.initials: AM
authors.lastname: Bays
authors.forename: Ruth A
authors.initials: RA
authors.lastname: Engelberg
authors.forename: Anthony L
authors.initials: AL
authors.lastname: Back
authors.forename: Dee W
authors.initials: DW
authors.lastname: Ford
authors.forename: Lois
authors.initials: L
authors.lastname: Downey
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Shannon
authors.forename: Ardith Z
authors.initials: AZ
authors.lastname: Doorenbos
authors.forename: Barbara
authors.initials: B
authors.lastname: Edlund
authors.forename: Phyllis
authors.initials: P
authors.lastname: Christianson
authors.forename: Richard W
authors.initials: RW
authors.lastname: Arnold
authors.forename: Kim
authors.initials: K
authors.lastname: O'Connor
authors.forename: Erin K
authors.initials: EK
authors.lastname: Kross
authors.forename: Lynn F
authors.initials: LF
authors.lastname: Reinke
authors.forename: Laura
authors.initials: L
authors.lastname: Cecere Feemster
authors.forename: Kelly
authors.initials: K
authors.lastname: Fryer-Edwards
authors.forename: Stewart C
authors.initials: SC
authors.lastname: Alexander
authors.forename: James A
authors.initials: JA
authors.lastname: Tulsky
authors.forename: J Randall
authors.initials: JR
authors.lastname: Curtis
mesh_terms: D000328:Adult; D002983:Clinical Competence; D004493:Education; D004503:Education, Medical, Graduate; D004511:Education, Nursing, Graduate; D005260:Female; D006801:Humans; D033183:Interdisciplinary Communication; D007388:Internal Medicine / Q000193:education; D007396:Internship and Residency; D008297:Male; D008875:Middle Aged; D009722:Nurse Practitioners / Q000193:education; D011368:Professional-Family Relations; D011369:Professional-Patient Relations; D015397:Program Evaluation