title: Teaching colleagues how to discuss prognosis as part of a hospital-wide quality improvement project: the positive impact of a 90-minute workshop.
abstract: BACKGROUND
  Many physicians have difficulty with discussions about prognosis. The aims of this study were to evaluate why physicians struggle to discuss prognosis and to measure the effect of a 90-minute communication workshop on self-reported skill.
  
  
  METHODS
  An evaluation study was used with three measurement points: before the 90-minute communication workshop (e-mail survey); immediately after the workshop (paper survey); and one month after the workshop (e-mail survey).
  
  
  METHODS
  Physicians from diverse specialties at a single academic institution were paid to participate in a 90-minute communication workshop on discussing prognosis.
  
  
  RESULTS
  Physicians identified several reasons why discussions of prognosis are hard: "I am not sure of the actual prognosis" (58.9%; 95% CI, 50.9, 66.5), "I worry I will take away hope (42.9%; 95% CI, 35.2, 50.9), and "I worry the patient is not ready to hear the information" (42.9%; 95% CI, 35.2, 50.9). Physicians who attended this short workshop reported that they could apply what was learned to their work immediately (4.6, range 1-5). One month after the workshop, 91% of respondents reported trying a skill learned in the workshop. The most frequently used skill was Ask/Tell/Ask (61.5%; 95% CI, 51.6, 70.6).
  
  
  CONCLUSIONS
  A short workshop on discussing prognosis was highly valued by physicians from diverse specialties and a majority reported using at least one of the communication skills learned.
authors: Massachusetts General Hospital, Boston, Massachusetts, USA. Electronic address: jjacobsen@partners.org.
authors: Juliet
authors: J
authors: Jacobsen
authors: Four Seasons Palliative Care, Flat Rock, North Carolina, USA.
authors: Sandra N
authors: SN
authors: Whitlock
authors: MGH Biostatistics Center and Harvard Medical School, Boston, Massachusetts, USA.
authors: Hang
authors: H
authors: Lee
authors: Massachusetts General Hospital, Boston, Massachusetts, USA.
authors: Charlotta
authors: C
authors: Lindvall
authors: Massachusetts General Hospital, Boston, Massachusetts, USA.
authors: Vicki
authors: V
authors: Jackson
mesh_terms: D001900:Boston; D003479:Curriculum; D004493:Education / Q000458:organization & administration*; D004502:Education, Medical, Continuing / Q000458:organization & administration*; D006739:Hospital Administration / Q000379:methods*; D007258:Informed Consent; D010353:Patient Education as Topic / Q000458:organization & administration*; D010817:Physician-Patient Relations; D011379:Prognosis; D058996:Quality Improvement
keywords: Communication; colleagues; prognosis; quality improvement