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

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2024年2月21日

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  • Oluwaseun Adeyemi,
  • Alexander D. Ginsburg,
  • Regina Kaur,
  • Allison M. Cuthel,
  • Nicole Zhao,
  • Nina Siman,
  • Keith S Goldfeld,
  • Lillian Liang Emlet,
  • Charles DiMaggio,
  • Rebecca Liddicoat Yamarik,
  • Jean-Baptiste Bouillon-Minois,
  • Joshua Chodosh,
  • Corita R. Grudzen,
  • Lauren T. Southerland,
  • Peg Gulker,
  • Andrew Johnston,
  • Arvind Venkat,
  • David Chuirazzi,
  • John O’Neill,
  • Kelly Szabo,
  • Rachel Urosek,
  • Ashley Deutsch,
  • Elizabeth Schoenfeld,
  • Melissa Shaw,
  • Tricia Guerino,
  • Alayna Perko,
  • Lauren Cameron- Comasco,
  • Michael Banish,
  • Pamela Sloan,
  • Robert Swor,
  • Ronny Otero,
  • Aaron Elliot,
  • Kim Reiner,
  • Nicole Hurd,
  • Brittany Ballaron,
  • Kei Ouchi,
  • Natasha Egorova,
  • Andrew Dundin,
  • Niza Troncoso,
  • Robin Powell,
  • Barbara J. Debbage,
  • Deborah Johnson,
  • John Powell,
  • Julie Cooper,
  • Doretha Graham-Brekke,
  • Erin Zimny,
  • Glenn Tokarski,
  • Joseph Miller,
  • Olive Sadia,
  • Christopher Richardson,
  • Jennifer Kroll,
  • Jennifer Siller,
  • Jessica Fleischer-Black,
  • Karen Evelyn,
  • Laura Stark,
  • Lauren Gordon,
  • Lynne Richardson,
  • Michelle Lin,
  • Audrey Tan,
  • Alicia Sommer,
  • Caitlin Loprinzi-Brauer,
  • Heather Heaton,
  • Laura Walker,
  • MFernanda Bellolio,
  • Molly Christenson,
  • Donna Shelley,
  • Audie Liametz,
  • Barry Rosenthal,
  • Ian Wittman,
  • Kathy Peterson,
  • Lila Hageman-Sheehan,
  • Rajneesh Gulati,
  • Robert Smeltz,
  • Staci Mandola,
  • Stephen Stark,
  • Suchismita Datta,
  • Susan Cohen,
  • Tisha Thompson,
  • Katharine Lawrence,
  • Abraham A. Brody,
  • Leora Horwitz,
  • Nicholas Genes,
  • Ashley Shreves,
  • Deidre Bolden,
  • Kelly Hutchinson,
  • Maureen Gang,
  • Rebecca Goett,
  • Sangeeta Lamba,
  • Eric Isaacs,
  • Jennifer Harris,
  • Karen Martinez,
  • Matthew Shaw,
  • Rebecca Murray,
  • Rosemarie Fernandez,
  • Shannon Bledsoe,
  • Travis Wood,
  • Matthew Ryan,
  • Benjamin S. Abella,
  • Elizabeth Long,
  • Gabriela De Hoyos,
  • Julie Uspal,
  • M. Bradley Falk,
  • Phillip Landis,
  • Ahmed Elsayem,
  • Cecilia Yniguez,
  • Danielle Milling,
  • Denise Langabeer,
  • Sorayah Bourenane,
  • Terri Cridge,
  • Troy Madsen,
  • Emilia Boutsioulis,
  • Hannah Nofsinger,
  • Karen Jubanyik,
  • Theresa Cohen,
  • Marie-Carmelle Elie

摘要

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.