DELIVERING BAD NEWS: COMMUNICATION STYLES AMONG 1
This presentation is the property of its rightful owner.
Sponsored Links
1 / 12

DELIVERING BAD NEWS: COMMUNICATION STYLES AMONG 1 ST YEAR IM RESIDENTS Carissa Pereda PowerPoint PPT Presentation


  • 80 Views
  • Uploaded on
  • Presentation posted in: General

DELIVERING BAD NEWS: COMMUNICATION STYLES AMONG 1 ST YEAR IM RESIDENTS Carissa Pereda Internal Medicine R3. End-of-life Communication: Problems and Importance. Patients report poor clinician-patient communication as primary concern 1 2

Download Presentation

DELIVERING BAD NEWS: COMMUNICATION STYLES AMONG 1 ST YEAR IM RESIDENTS Carissa Pereda

An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -

Presentation Transcript


Delivering bad news communication styles among 1 st year im residents carissa pereda

DELIVERING BAD NEWS: COMMUNICATION STYLES AMONG 1ST YEAR IM RESIDENTS

Carissa Pereda

Internal Medicine R3


End of life communication problems and importance

End-of-life Communication: Problems and Importance

  • Patients report poor clinician-patient communication as primary concern1 2

  • Trainees report being uncomfortable and untrained in end of life communication

  • Trainees’ self-reported competence not associated with patient/family assessments

  • Trainees benefit from experiential trainings


Improving clinician communication skills study

Improving Clinician Communication Skills Study

  • Design: RCT of interdisciplinary communication intervention– “CodeTalk”1

  • Goal: to improve end-of-life communication skills among MD, NP trainees

  • Curriculum: experiential, adult learning

    • Communication strategies (SPIKES, NURSE)

    • Practice with simulated patients

  • Evaluation:

    • Outcomes: Patient, family, clinician surveys of trainee communication skills

    • Process: Pre- and post- intervention audiorecordings of trainees with standardized patients

  • 1Curtis et al.


    Study goal what do trainees do

    Study Goal: What Do Trainees Do?

    • How do trainees respond to patients, prior to workshop training?

      • Recognizing diversity of communication styles

      • Identifying/describing these styles/techniques

      • Reproducibility with existing data?

        • Standardized patient interviews with required behaviors or “triggers”

          • “I have to tell you, I’m really scared”

          • “Is there any hope for a cure”


    Methods and materials

    Methods and Materials

    • Sample: pre-intervention audiotapes (n=173)

      • MUSC, n=60; UW, n= 113

      • Trainees: 1st year IM residents

      • Random selection of 50 pre-intervention recordings

  • Standardized patient interviews

    • “Cathy” with recurrent ovarian cancer

    • “Thomas” with recurrent colon cancer


  • Interviews

    Interviews

    • Resident task: Deliver results of a CT scan:

      • Recurrent cancer (colon and ovarian) with metastases

    • Patient task: Stay in character!

      • Provide 3 behaviors at any point during the interview

        • 20 second silence post bad news

        • “I have to tell you, I’m really scared”

        • “Is there any hope for a cure”


    Analysis

    Analysis

    • Goals:

      • Identify and describe communication techniques utilized by residents in response to target statements

      • Develop a framework of “codes” to describe/evaluate communication techniques

    • Methods:

      • Team (n=3) established codes from 5 audios

      • Single investigator coded and compared subset of audiotapes to assess trustworthiness (n=25)

      • Trainees review subset (n=5-10) for validity


    Codebook

    CODEBOOK


    Is there any hope for a cure

    Is there any hope for a cure?

    • I can’t be a 100%. Right now it looks like your disease would actually be classified as stage 4. I don’t know if you know the stages of cancer, but stage 4 would be the end stage, meaning that it has spread from the colon to another part of the body.

    • I can’t really answer that question. I wish I could. I think it’s better if you talk to the oncologist. If they could offer you surgery, maybe there’s a small chance for a cure. I can’t comment on exactly what your prognosis is going to be.


    I have to tell you i m really scared

    I have to tell you, I’m really scared.

    • Tell me more about that. What is making you feel scared?

    • That’s very understandable. It is normal to be scared.


    The single biggest problem with communication is the illusion that it has taken place george shaw

    “The single biggest problem with communication is the illusion that it has taken place.”-George Shaw

    MANY THANKS:

    -Research Team

    -Randy Curtis

    -Ruth Engelberg

    -Erin Kross

    -GOOGLE images

    -Invaluable mountain of prior research


  • Login