iValidate: a communication-based clinical intervention in life-limiting illness

Abstract

ObjectivesReport the implementation, user evaluation and key outcome measures of an educational intervention—the iValidate educational programme—designed to improve engagement in shared decision-making by health professionals caring for patients with life-limiting illness (LLI).DesignProspective, descriptive, cohort study.ParticipantsHealth professionals working in acute care settings caring for patients with an LLI.Main outcomes measuredParticipant evaluation of learning outcomes for communication skills and shared decision-making; demographic data of participants attending education workshops; and documentation of patients with LLI goals of management, including patient values and care decision based on area in acute care and seniority of doctor.ResultsThe programme was well accepted by participants. Participant evaluations demonstrated self-reported improved confidence in the areas of patient identification, information gathering to ascertain patient values and shared decision-making. There was strong agreement with the course-enhanced knowledge of core communication skills and advanced skills such as discussing mismatched agendas.ConclusionsWe described the educational pedagogy, implementation and key outcome measures of the iValidate education programme, an intervention designed to improve person-centred care for patients with an LLI. A targeted education programme could produce cultural and institutional change for vulnerable populations within a healthcare institution. A concurrent research programme suggests effectiveness within the current service and the potential for transferability.

Challenges for nurses when communicating with people who have life‐limiting illness and their families: A focus group study

“…However, few recalled receiving explicit CST during their undergraduate course, and fewer than 40% had undergone post graduate training.Some participants employed in the palliative care ward reported on their experience of CST as part of a Master of Palliative Care course, which incorporated online theory, face-to-face workshops and role plays. Others discussed participation in the organisation's training program, iValidate, which is usually delivered as a two-day face to face workshop and includes theory and experiential learning and role play(Simpson et al, 2019). iValidate is a clinical communication training program, designed specifically for communicating with patients with LLI, which is founded on identifying values, listening, and advising.…”

Communication skills: simulated patient goals of care workshop for acute care clinicians

“…Role-playing scenarios are known to impact self-assessments, where participants become aware of deficiencies in their knowledge and skills, and falsely overvalue their confidence in a preintervention questionnaire 43. Using a retrospective pre–post questionnaire avoids response-shift bias and has been used in another CST programme 27. Limitations of this method include recall bias and participants voluntarily reporting improvement in their skills leading to a type I error.…”

“…During the role play participants could pause the simulation by requesting a ‘time-out’ to seek guidance from the group in negotiating communication roadblocks. Real-time feedback was guided by the facilitators using the agenda-led outcome-based analysis (ALOBA) format, which has been used effectively in similar workshops 27 28. The ALOBA method identifies the learner’s agenda and focuses positive and constructive feedback toward learner‐identified goals, encouraging collaboration and teamwork among the group to generate solutions 29.…”

Education modalities for serious illness communication training: A scoping review on the impact on clinician behavior and patient outcomes

“…Studies N = 64 References E-learning alone 4 Schmitz et al, 25 Malhotra et al, 26 Szmuilowicz et al, 27 Wayne et al, 28 Sharma et al, 29 Shaw et al 30 Single workshop 29 a Banerjee et al, 31 Chen et al, 32 Clayton et al, 33 Fujimori et al, 34 Garcia et al, 35 Hamilton et al, 36 Johnson et al, 37 Karim et al, 38 Kistler et al, 39 Korc-Grodzicki et al, 40 Shen et al, 41 Pehrson et al, 42 Schell et al, 43 Williams et al, 44 Wu et al, 45 Roberts et al, 46 Zimmermann et al, 47 Detering et al, 48 Peltier et al, 49 Bernacki et al, 50 Geerse et al, 51 Paladino et al, 52,53 Geerse et al, 54 Christensen et al, 55 Daly et al, 56 Okada et al, 57 Ouchi et al, 58,59 Simpson et al, 60 Wasp et al, 61 Zehm et al, 62 Bos-Van Den Hoek et al, 63 Frydman et al, 64 Vergo et al 65 Single workshop with coaching 7 Bickell et al, 66 Annadurai et al, 67 Epstein et al, 68 Goelz et al, …”