The Impact of Communication Skills Training on Cardiology Fellows' and Attending Physicians' Perceived Comfort with Difficult Conversations

Berlacher, Kathryn; Arnold, Robert M.; Reitschuler-Cross, Eva; Teuteberg, Jeffrey J.; Teuteberg, Winifred

doi:10.1089/jpm.2016.0509

Cited by 34 publications

(29 citation statements)

References 8 publications

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“…To estimate Re-ACT’s reach, we documented the number of unique accounts that logged into each session and activity on the ACT Program’s website (e.g., unique visitors, page views, and downloads). The impact of both ACT and Re-ACT were evaluated using a survey modified from Berlacher, et al 14 (Supplementary Materials). Briefly, the survey assessed self-rated preparedness for SICs, and the extent to which respondents would recommend Re-ACT to a busy colleague.…”

Section: Methodsmentioning

confidence: 99%

Re-ACT: Remote Advanced Communication Training in a Time of Crisis

Carroll

Mooney

Horowitz

2021

Journal of Pain and Symptom Management

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Background. We used a quality improvement framework to transform two-day and in-person advanced communication training (ACT) course into a remote ACT (Re-ACT) format to help clinicians improve serious illness conversation (SIC) skills. Measures. We assessed the reach, impact, and costs of ReACT and compared these measures to in-person ACT courses. Interventions. About 45e60 minutes of synchronous, remote sessions consisting of a didactic introduction to SIC skills, tailored to the SARS-Cov-2 (COVID-19) crisis, and a live demonstration of SICs with patient-actors. Outcomes. The transition to ReACT sessions resulted in reaching a greater number of clinicians in less time, although depth of content and opportunities for skill practice decreased. Although both formats were well received, ReACT respondents felt less prepared than ACT respondents to use SIC skills. The costs of ReACT were significantly less than inperson ACT courses. Conclusions/Lessons Learned. We provided effective and well-received SIC training during a time of crisis. Future work should further define the optimal mix of in-person and remote experiences to teach SIC skills.

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Section: Methodsmentioning

confidence: 99%

Re-ACT: Remote Advanced Communication Training in a Time of Crisis

Carroll

Mooney

Horowitz

2021

Journal of Pain and Symptom Management

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“…Indeed, all clinicians caring for patients with serious illness, like HF, should possess a fundamental palliative proficiency to alleviate suffering (e.g., basic management of physical and psychological symptoms, eliciting goals of care, responding to family concerns) (14). Initial efforts to educate cardiology fellows in palliative care competencies, such as communication, are underway (60,61). Research is needed to understand how to improve education regarding primary palliative care domains that are relevant to patients with advanced HF, such as elicitation of goals of care, advance care planning, and caregiver support.…”

Section: Priorities For Future Research and Clinical Implementation Omentioning

confidence: 99%

Palliative Care in Heart Failure

Kavalieratos

Gelfman

Tycon

et al. 2017

Journal of the American College of Cardiology

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223

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Patients with HF and their families experience stress and suffering from a variety of sources over the course of the HF experience. Palliative care is an interdisciplinary service and an overall approach to care that improves quality of life and alleviates suffering for those living with serious illness, regardless of prognosis. In this review, we synthesize the evidence from randomized clinical trials of palliative care interventions in HF. While the evidence base for palliative care in HF is promising, it is still in its infancy and requires additional high-quality, methodologically sound studies to clearly elucidate the role of palliative care for patients and families living with the burdens of HF. Yet, an increase in attention to primary palliative care (e.g., basic physical and emotional symptom management, advance care planning), provided by primary care and cardiology clinicians, may be a vehicle to address unmet palliative needs earlier and throughout the illness course.

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“…The reasons may include lack of willingness, busy schedules, strict implementation of prevalent medical practice, lack of experience, or inability to communicate adequately. Regrettably, this situation persists at a time when available data attest to the advantages of training physicians in communication skills (Berlacher et al, 2017). In fact, the general rule in cardiology is to proceed strictly in line with current guidelines and historic practices.…”

Section: Discussionmentioning

confidence: 99%

End-of-life preferences of cardiac patients

Gřiva¹,

Šťastný²,

Švancara³

et al. 2018

Cent Eur J Nurs Midw

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Aim: To address the wishes of patients with cardiovascular disease in relation to their end-of-life stagean issue that has long been regarded taboo. Design: Cross-sectional study. Methods: After an initial interview, 127 patients completed an anonymous questionnaire: 86 patients (67.7%) hospitalized in a cardiology department, and 41 patients (32.3%) on follow-up at an outpatient clinic. The mean age was 67 ± 13 years; 60.6% were male; 51.7% were NYHA class III. Seventeen patients (13.4%) had an implantable cardioverter-defibrillator. Results: The patients most concerned about their future were those aged 65-79 years (p = 0.044); patients who felt they were not receiving sufficient information (p = 0.008); hospitalized patients (p < 0.001); or those with a known diagnosis of less than one month, or over one year (p = 0.038). Seventy-one patients (57.7%) would prefer to die at home, although this would mean receiving less health care than in hospital. Only 19 patients (15.4%) expressed a preference for extension of life over quality of life. Twenty-nine patients (23.6%) would contemplate having their cardioverter-defibrillator deactivated. 90.2% subjects considered it important for physicians to be interested in the views of patients regarding these issues. Conclusion: Despite the contrast with practice in some countries, most patients with cardiovascular disease would appreciate physicians being interested in their attitudes to the issue of end of life. An adequate level of information would help reduce patient concerns about their futures.

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The Impact of Communication Skills Training on Cardiology Fellows' and Attending Physicians' Perceived Comfort with Difficult Conversations

Abstract: All learners improved in levels of PP in communication competencies. CardioTalk is the first described training program that prepares cardiologists for the challenges they face when having conversations with seriously ill patients.

Cited by 34 publications

References 8 publications

Re-ACT: Remote Advanced Communication Training in a Time of Crisis

Re-ACT: Remote Advanced Communication Training in a Time of Crisis

Palliative Care in Heart Failure

End-of-life preferences of cardiac patients

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