Development and preliminary evaluation of a communication skills training programme for hospital physicians by a specialized palliative care service: the ‘Teach to Talk’ programme

Abstract

Background There is widespread agreement about the importance of communication skills training (CST) for healthcare professionals caring for cancer patients. Communication can be effectively learned and improved through specific CST. Existing CSTs have some limitations with regard to transferring the learning to the workplace. The aim of the study is developing, piloting, and preliminarily assessing a CST programme for hospital physicians caring for advanced cancer patients to improve communication competences. Methods This is a Phase 0-I study that follows the Medical Research Council framework; this paper describes the following sections: a literature review on CST, the development of the Teach to Talk training programme (TtT), the development of a procedure for assessing the quality of the implementation process and assessing the feasibility of the implementation process, and the pilot programme. The study was performed at a 900-bed public hospital. The programme was implemented by the Specialized Palliative Care Service. The programme was proposed to 19 physicians from 2 departments. Results The different components of the training course were identified, and a set of quality indicators was developed. The TtT programme was implemented; all the physicians attended the lesson, videos, and role-playing sessions. Only 25% of the physicians participated in the bedside training. It was more challenging to involve Haematology physicians in the programme. Conclusions The programme was completed as established for one of the two departments in which it was piloted. Thus, in spite of the good feedback from the trainees, a re-piloting of a different training program will be developed, considering in particular the bed side component. The program should be tailored on specific communication attitude and believes, probably different between different specialties.

Behavioral Patterns in Breaking Bad News Communication: An Ethnographic Study with Hematologists

“…In Alexander and colleagues [8], audio-recorded consultations between patients and hematologists were analyzed; the hematologists commonly discussed the disease and treatment but less widely discussed other, more patient-centered issues such as decisionmaking preferences and information preferences, similar results in our study As specialized professionals in PC and facilitators of communication training [27], we try to teach serious attention to the values, preferences, quality-of-life dimensions, and concerns of our patients during difficult conversations; this type of active listening and attention is fundamental for being supportive and being helpful to vulnerable patients in the advanced stages of a disease. As shown in the authoritative pattern, Hematologists frequently provide rich recommendations during their discussions about treatment.…”

“…A training program titled the “Teach-to-talk” was implemented within the participants’ hospital ward [ 27 ]. The trainers were professionals from the Palliative Care Unit.…”

“…The participants proposed the communication scenarios based on real situations they experienced in the field. The bad news to communicate entailed the following topics: the end of active treatments, poor prognosis, and interference from relatives/caregivers [ 27 ]. Roleplaying scenarios and structures are shown in Table 1 .…”

“…Since there is room for improvement in communication in hematology, in 2015, a group of psycho-oncologists and palliative care specialists, working in a Palliative Care Unit within a general hospital, implemented training on communicating bad news, which was described in a recent publication [ 27 ] (the Teach-to-Talk program). The training was designed by adopting different teaching methods: lectures, role-play, bedside training.…”

Communication About End of Life for Patients Living With Amyotrophic Lateral Sclerosis: A Scoping Review of the Empirical Evidence

“…Moreover, most of the reviewed articles addressed end-of-life communication as a peripheral focus of investigation. In keeping with other studies, this review highlights the need for generic communication skills, including empathy and relationship building ( 151 – 154 ). Findings, however, bring attention to the importance of providing substantive and sufficient disease-related information, including information about symptom management and assistive devices, when discussing end-of-life issues.…”