title: Self-Assessment Scores Improve After Simulation-Based Palliative Care Communication Skill Workshops.
abstract: BACKGROUND
  We conducted a randomized trial of a simulation-based multisession workshop to improve palliative care communication skills (Codetalk). Standardized patient assessments demonstrated improved communication skills for trainees receiving the intervention; however, patient and family assessments failed to demonstrate improvement. This article reports findings from trainees' self-assessments.
  
  
  OBJECTIVE
  To examine whether Codetalk resulted in improved self-assessed communication competence by trainees.
  
  
  METHODS
  Trainees were recruited from the University of Washington and the Medical University of South Carolina. Internal medicine residents, medicine subspecialty fellows, nurse practitioner students, or community-based advanced practice nurses were randomized to Codetalk, a simulation-based workshop, or usual education. The outcome measure was self-assessed competence discussing palliative care needs with patients and was assessed at the start and end of the academic year. We used robust linear regression models to predict self-assessed competency, both as a latent construct and as individual indicators, including randomization status and baseline self-assessed competency.
  
  
  RESULTS
  We randomized 472 trainees to the intervention (n = 232) or usual education (n = 240). The intervention was associated with an improvement in trainee's overall self-assessment of competence in communication skills ( P < .001). The intervention was also associated with an improvement in trainee self-assessments of 3 of the 4 skill-specific indicators-expressing empathy, discussing spiritual issues, and eliciting goals of care.
  
  
  CONCLUSIONS
  Simulation-based communication training was associated with improved self-assessed competency in overall and specific communication skills in this randomized trial. Further research is needed to fully understand the importance and limitations of self-assessed competence in relation to other outcomes of improved communication skill.
authors.affiliation: 1 Division of Pulmonary and Critical Care, Department of Medicine, Harborview Medical Center, University of Washington, Seattle WA, USA.
authors.forename: Crystal E
authors.initials: CE
authors.lastname: Brown
authors.affiliation: 2 Division of Medical Oncology, Department of Medicine, Seattle Cancer Care Alliance, University of Washington and Fred Hutchinson Cancer Research Center, Seattle WA, USA.
authors.forename: Anthony L
authors.initials: AL
authors.lastname: Back
authors.affiliation: 3 Division of Pulmonary and Critical Care, Department of Medicine, Medical University of South Carolina, Charleston, SC, USA.
authors.forename: Dee W
authors.initials: DW
authors.lastname: Ford
authors.affiliation: 1 Division of Pulmonary and Critical Care, Department of Medicine, Harborview Medical Center, University of Washington, Seattle WA, USA.
authors.forename: Erin K
authors.initials: EK
authors.lastname: Kross
authors.affiliation: 1 Division of Pulmonary and Critical Care, Department of Medicine, Harborview Medical Center, University of Washington, Seattle WA, USA.
authors.forename: Lois
authors.initials: L
authors.lastname: Downey
authors.affiliation: 4 School of Nursing, Oregon Health & Sciences University, Portland, OR, USA.
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Shannon
authors.affiliation: 1 Division of Pulmonary and Critical Care, Department of Medicine, Harborview Medical Center, University of Washington, Seattle WA, USA.
authors.forename: J Randall
authors.initials: JR
authors.lastname: Curtis
authors.affiliation: 1 Division of Pulmonary and Critical Care, Department of Medicine, Harborview Medical Center, University of Washington, Seattle WA, USA.
authors.forename: Ruth A
authors.initials: RA
authors.lastname: Engelberg
mesh_terms: D000328:Adult; D057179:Advanced Practice Nursing / Q000193:education; D002983:Clinical Competence; D003142:Communication; D005260:Female; D006282:Health Personnel / Q000193:education*; D006801:Humans; D007396:Internship and Residency / Q000379:methods; D008297:Male; D009722:Nurse Practitioners / Q000193:education; D010166:Palliative Care; D016544:Patient Simulation; D012647:Self-Assessment
keywords: communication skills; end-of-life communication; palliative care; self-assessment; self-efficacy