Journal Article

Serious illness communication skills training for emergency physicians and advanced practice providers: a multi-method assessment of the reach and effectiveness of the intervention

Siman, Nina, Emlet, Lillian Liang, Chodosh, Joshua, Cuthel, Allison M., Yamarik, Rebecca Liddicoat, Kaur, Regina, Ginsburg, Alexander D., Bouillon-Minois, Jean-Baptiste, Adeyemi, Oluwaseun, DiMaggio, Charles, Grudzen, Corita R., Goldfeld, Keith S, Zhao, Nicole

2024

Overview

Background EM Talk is a communication skills training program designed to improve emergency providers’ serious illness conversational skills. Using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework, this study aims to assess the reach of EM Talk and its effectiveness. Methods EM Talk consisted of one 4-h training session during which professional actors used role-plays and active learning to train providers to deliver serious/bad news, express empathy, explore patients’ goals, and formulate care plans. After the training, emergency providers filled out an optional post-intervention survey, which included course reflections. Using a multi-method analytical approach, we analyzed the reach of the intervention quantitatively and the effectiveness of the intervention qualitatively using conceptual content analysis of open-ended responses. Results A total of 879 out of 1,029 (85%) EM providers across 33 emergency departments completed the EM Talk training, with the training rate ranging from 63 to 100%. From the 326 reflections, we identified meaning units across the thematic domains of improved knowledge, attitude, and practice. The main subthemes across the three domains were the acquisition of Serious Illness (SI) communication skills, improved attitude toward engaging qualifying patients in SI conversations, and commitment to using these learned skills in clinical practice. Conclusion Our study showed the extensive reach and the effectiveness of the EM Talk training in improving SI conversation. EM Talk, therefore, can potentially improve emergency providers’ knowledge, attitude, and practice of SI communication skills. Trial registration Clinicaltrials.gov: NCT03424109; Registered on January 30, 2018.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Attitudes / Caregivers / Clinical Competence / Communication / Data analysis / Education and training / Emergency medical care / Emergency medicine / Emergency Medicine - education / Human health and pathology / Humans / Intervention / Knowledge acquisition / Life Sciences / Medical education / Medicine / Medicine & Public Health / Nurses / Older people / Oncology / Pain Medicine / Palliative care / Palliative Medicine / Palliative treatment / Patients / Physicians / Practice / Qualitative research / Quality of Life Research / Serious illness conversation / Skill development / Skills / Training / Verbal communication / VitalTalk