A systematic scoping review of teaching and evaluating communications in the intensive care unit

Abstract

Introduction: Whilst the importance of effective communications in facilitating good clinical decision-making and ensuring effective patient and family-centred outcomes in Intensive Care Units (ICU)s has been underscored amidst the global COVID-19 pandemic, training and assessment of communication skills for healthcare professionals (HCPs) in ICUs remain unstructured. Methods: To enhance the transparency and reproducibility, Krishna’s Systematic Evidenced Based Approach (SEBA) guided Systematic Scoping Review (SSR), is employed to scrutinise what is known about teaching and evaluating communication training programmes for HCPs in the ICU setting. SEBA sees use of a structured search strategy involving eight bibliographic databases, the employ of a team of researchers to tabulate and summarise the included articles and two other teams to carry out content and thematic analysis the included articles and comparison of these independent findings and construction of a framework for the discussion that is overseen by the independent expert team. Results: 9532 abstracts were identified, 239 articles were reviewed, and 63 articles were included and analysed. Four similar themes and categories were identified. These were strategies employed to teach communication, factors affecting communication training, strategies employed to evaluate communication and outcomes of communication training. Conclusion: This SEBA guided SSR suggests that ICU communications training must involve a structured, multimodal approach to training. This must be accompanied by robust methods of assessment and personalised timely feedback and support for the trainees. Such an approach will equip HCPs with greater confidence and prepare them for a variety of settings, including that of the evolving COVID-19 pandemic.

Evidence-guided approach to portfolio-guided teaching and assessing communications, ethics and professionalism for medical students and physicians: a systematic scoping review

“…A Systematic Evidence-Based Approach (SEBA) guided Systematic Scoping Review (SSR) (henceforth SSR in SEBA) is proposed to map CEP portfolio use in medicine to guide the design, structuring and support of a proposed programme 13–17 20–22 24 25 27–50. Given space constraints, we briefly describe the six stages in the construction of SSRs in SEBA in figure 1 and more advanced details of the systematic approach, split approach, jigsaw perspective, funnelling process, reiterative process and synthesis of SSR in online supplemental appendix A 16 27 28 35 41 48 51–56…”

“…As sociocultural constructs, 2 CEP competencies are shaped by the individual's personal experiences, motivations, enthusiasm, idealism, abilities, competencies, virtues, expectations, knowledge, skills, emotions and attitudes (henceforth narratives); their values, beliefs and principles (henceforth belief systems) 3 ; their clinical experiences, competencies, training, insights and confidence (henceforth clinical insights); [4][5][6][7] and their practice, clinical, social, cultural, academic, research and personal considerations (henceforth contextual considerations). [8][9][10][11][12] However, while previous reviews into the teaching of ethics, [13][14][15] communication [16][17][18][19][20][21][22] and professionalism [23][24][25] suggest the use of portfolios could provide a personalised, holistic and longitudinal perspective of CEP skills, knowledge and attitudes and support of developing competencies, we are aware of little progress in designing such platforms. Impetus for mapping current use of CEP portfolios also arises from the notion that developing CEP competencies shapes how medical students and physicians (henceforth clinician) 'think, act and feel like a physician' 26 or their professional identity formation (henceforth PIF).…”

“…However, while previous reviews into the teaching of ethics,13–15 communication16–22 and professionalism23–25 suggest the use of portfolios could provide a personalised, holistic and longitudinal perspective of CEP skills, knowledge and attitudes and support of developing competencies, we are aware of little progress in designing such platforms. Impetus for mapping current use of CEP portfolios also arises from the notion that developing CEP competencies shapes how medical students and physicians (henceforth clinician) ‘think, act and feel like a physician’26 or their professional identity formation (henceforth PIF) 27.…”

A systematic scoping review on patients’ perceptions of dignity

“…Krishna's Systematic Evidence-Based Approach (SEBA) is adopted to guide this systematic scoping review (SSR) (henceforth SSR in SEBA) [40,[45][46][47][48][49][50][51]. The aim of this review is to identify available data, key characteristics and knowledge gaps in current concepts of dignity in the literature.…”

A systematic scoping review of reflective writing in medical education

“…The authors suggest that the physician’s belief system informs and is informed by their self-concepts of identity which are in turn rooted in their self-concepts of personhood - how they conceive what makes them who they are [ 11 ]. This posit not only ties reflective practice to the shaping of the physician’s moral and ethical compass but also offers evidence of it's role in their professional identity formation (PIF) [ 8 , 12 – 23 ]. With PIF [ 8 , 24 ] occupying a central role in medical education, these ties underscore the critical importance placed on integrating reflective practice in medical training.…”