title: Effectiveness of the 'availability, current issues and anticipation' (ACA) training programme for general practice trainees on communication with palliative care patients: a controlled trial.
abstract: OBJECTIVE
  This study aimed to evaluate the effectiveness of a new palliative care 'availability, current issues and anticipation' (ACA) training programme to improve communication skills of general practice trainees (GPTs).
  
  
  METHODS
  In a controlled trial among third-year GPTs, we videotaped one 20-min consultation between each GPT and a simulated palliative care patient at baseline and at six months follow-up. We measured the number of issues discussed and the quality of communication skills and analysed between-group differences using linear mixed models and logistic regression.
  
  
  RESULTS
  Fifty-four GPTs were assigned to the intervention and 64 to the control group. We found no effect of the programme on the number of issues discussed or on the quality of GPT communicative behaviour. GPTs infrequently addressed 'spiritual/existential issues' and 'unfinished business'. In a selection of the consultations, simulated patients brought up more issues than the GPTs did.
  
  
  CONCLUSIONS
  The ACA training programme was not effective in the way it was carried out and evaluated in this trial.
  
  
  CONCLUSIONS
  The ACA programme should focus on the issues that scored low in this trial. Future research on GPT-patient communication in palliative care should consider using real patients in a series of consultations to evaluate effectiveness.
authors.affiliation: Department of General Practice & Elderly Care Medicine, EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands. Electronic address: w.slort@vumc.nl.
authors.forename: Willemjan
authors.initials: W
authors.lastname: Slort
authors.affiliation: Department of General Practice & Elderly Care Medicine, EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Annette H
authors.initials: AH
authors.lastname: Blankenstein
authors.affiliation: Department of General Practice & Elderly Care Medicine, EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Bart P M
authors.initials: BP
authors.lastname: Schweitzer
authors.affiliation: Department of Public and Occupational Health, EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands; End-of-Life Care Research Group, Vrije Universiteit Brussel & Ghent University, Brussels, Belgium.
authors.forename: Luc
authors.initials: L
authors.lastname: Deliens
authors.affiliation: Department of General Practice & Elderly Care Medicine, EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Henriëtte E
authors.initials: HE
authors.lastname: van der Horst
mesh_terms: D002983:Clinical Competence; D003142:Communication; D005260:Female; D017144:Focus Groups; D005500:Follow-Up Studies; D058006:General Practice / Q000193:education* / Q000592:standards; D058005:General Practitioners / Q000193:education* / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010166:Palliative Care / Q000379:methods* / Q000523:psychology / Q000592:standards; D016544:Patient Simulation; D010817:Physician-Patient Relations; D011365:Professional Practice Location; D015397:Program Evaluation; D014741:Video Recording
keywords: Communication; Controlled clinical trial; Education; Family practice; General practice vocational training; Palliative care