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Teaching Pediatric Palliative Care Communication Skills to Fourth-Year Medical Students Through Role-Play.

ABSTRACT: Introduction:Despite growing recognition of pediatric palliative care's importance, training in palliative care communication remains a gap in medical education. Graduating medical students frequently feel unprepared to initiate or facilitate goals of care conversations with their patients, particularly in pediatrics. Methods:We created a 3-hour session featuring an introductory lecture on pediatric palliative care, communication drills on responding to emotion, and small-group case-based discussions utilizing role-play, targeting fourth-year medical students as the primary learners. Senior residents were also given the opportunity to develop skills by role-playing the patient parent and cofacilitating case discussions alongside palliative care faculty. Students evaluated session utility and their own confidence through pre- and postsession surveys using a 5-point Likert scale (1 = strongly disagree, 5 = strongly agree). Results:Twenty-six students were included in the analysis over 3 years. All agreed that the session was useful (M = 4.9). Students showed significant improvement in confidence in explaining pediatric palliative care (presession M = 3.2, postsession M = 4.1, p < .001), understanding the family experience (presession M = 2.7, postsession M = 4.1, p < .001), and eliciting goals and values from families whose children face serious illnesses (presession M = 3.1, postsession M = 4.1, p < .001). Pediatric resident cofacilitators also felt the session benefited their own teaching and communication skills. Discussion:This 3-hour interactive session on pediatric palliative care utilizing communication drills and role-play was effective in improving fourth-year medical students' confidence in communicating with families of children facing life-threatening illnesses.

SUBMITTER: Cowfer B

PROVIDER: S-EPMC7566222 | biostudies-literature | 2020 Oct

REPOSITORIES: biostudies-literature

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Teaching Pediatric Palliative Care Communication Skills to Fourth-Year Medical Students Through Role-Play.

Cowfer Brittany B McGrath Caitlin C Trowbridge Amy A

MedEdPORTAL : the journal of teaching and learning resources 20201016

<h4>Introduction</h4>Despite growing recognition of pediatric palliative care's importance, training in palliative care communication remains a gap in medical education. Graduating medical students frequently feel unprepared to initiate or facilitate goals of care conversations with their patients, particularly in pediatrics.<h4>Methods</h4>We created a 3-hour session featuring an introductory lecture on pediatric palliative care, communication drills on responding to emotion, and small-group ca ...[more]

PMID: 33094157

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Project description:BackgroundPatient-clinician communication training is a core component of the undergraduate medical program. As with all areas of medicine, the best available evidence for teaching these skills should be incorporated into training programs. Examining the volume, type and design-quality of publications in this field can help to determine whether research is following a natural scientific progression to inform interactional skills training. This study aimed to review: (i) whether the proportion of publications examining teaching interactional skills to undergraduate medical students by study type, across three time-periods (2007-2008, 2011-2012, 2015-2016), changed over time (i.e. measurement, descriptive or interventions studies); and (ii) the proportion of intervention studies meeting Cochrane Effective Practice and Organisation of Care (EPOC) research design criteria.MethodsMedline, PubMed, PsycInfo and the Cochrane Database were searched for studies published in English from 2007 to 2016. Title and abstract reviews were performed for the included years. Articles were examined against the inclusion/exclusion criteria and those included were coded into descriptive, measurement or intervention categories.ResultsA total of 243 relevant publications were identified. Fifty-two were published from 2007 to 2008, 75 from 2011 to 2012 and 116 from 2015 to 2016. Most identified studies were descriptive (63%), followed by measurement studies (22%) and intervention studies (15%). The proportion of descriptive studies increased significantly over time. However, the proportion of intervention studies did not change and the proportion of measures studies significantly decreased. Of the 37 intervention studies identified within the three time-periods, only 16 (43%) met EPOC study design criteria.ConclusionsThe largest proportion of identified studies were descriptive, however, descriptive research is not sufficient to ensure communication skills training can effectively improve interactions between clinicians and patients. A more rigorous approach to research in this area is needed to inform education strategies.

Project description:Background: Verbal and non-verbal communication, as well as empathy are central to patient-doctor interactions and have been associated with patients' satisfaction. Non-verbal communication tends to override verbal messages. The aim of this study was to analyze how medical students use verbal and non-verbal communication using two different educational approaches, student role play (SRP) and actor simulated patient (ASP), and whether the non-verbal behaviour is different in the two different poses.Methods: Three raters evaluated 20 students playing the doctor role, 10 in the SRP group and 10 in the ASP group. The videos were analyzed with the Calgary-Cambridge Referenced Observation Guide (CCG) and, for a more accurate evaluation of non-verbal communication, we also evaluated signs of nervousness, and posture. Empathy was rated with the CARE questionnaire. Independent Mann Whitney U tests and Qhi square tests were performed for statistical analysis.Results: From the 6 main tasks of the CCG score, we obtained higher scores in the ASP group for the task 'Gathering information' (p?=?0.0008). Concerning the 17 descriptors of the CCG, the ASP group obtained significantly better scores for 'Exploration of the patients' problems to discover the biomedical perspective' (p?=?0.007), 'Exploration of the patients' problems to discover background information and context' (p?=?0.0004) and for 'Closing the session - Forward planning' (p?=?0.02). With respect to non-verbal behaviour items, nervousness was significantly higher in the ASP group compared to the SRP group (p?<?0.0001). Concerning empathy, no differences were found between the SRP and ASP groups.Conclusions: Medical students displayed differentiated verbal and non-verbal communication behaviour during the two communication skills training methodologies. These results show that both methodologies have certain advantages and that more explicit non-verbal communication training might be necessary in order to raise students' awareness for this type of communication and increase doctor-patient interaction effectiveness.

Project description:BACKGROUND:Communication skills (CS) are vital for doctors. Indeed, as the most important element of consultations, are highly valued by patients. CS are core, teachable skills, however, have not been widely taught in South Asian medical schools, unlike their western counterparts. Patan Academy of Health Sciences, is one of the first in Nepal to have CS central to its' aims and curriculum. CS are taught from the first weeks of medical school and re-enforced during preclinical study (first 2 years). Our study seeks to explore students' perceptions and experiences of CS teaching in this South Asian, Nepal context. METHODS:This study is a qualitative evaluation of a CS course in Nepal, exploring the experiences and perceptions of participants. The study aims to also identify aspects that were helpful or not for student learning and areas for potential development. A purposive sample of twenty: second, fourth and Intern year students was selected for interview. Data were collected through audio recorded semi-structured interviews following a piloted schedule. Interview transcripts were manually coded and thematically analysed. Codes were arranged into themes and subthemes. RESULTS:The two main themes: 1. Positivity 2. Experiential learning. Results demonstrate participants' positive perceptions of CS teaching: believing it is important, effective, relevant and valuable for personal development. Participants identified experiential learning features as valuable for CS acquisition. Intern students recognised CS relevance and requested expanding teaching to clinical years,incorporating challenging communication scenarios. DISCUSSION:This study shows that PAHS' CS course is well perceived and valuable to learners. Experiential learning is powerful for CS development. Expansion of formal, structured CS teaching through all years in a spiral curriculum, should be considered. Violence towards doctors in South Asia is increasing. Students recognised CS teaching's significance in addressing this. CONCLUSION:CS teaching,still in its' infancy in South Asia, is a pressing issue for medical educators here. Our study provides evidence it is well perceived with positive impacts in this context, particularly when employing experiential learning. Medical schools in south Asia should be encouraged to incorporate and strengthen their CS teaching curriculum. .

Project description:In the model medical curriculum HannibaL at Hannover Medical School (MHH, Hannover, Germany), communication skills in taking case histories and disclosing diagnoses (breaking bad news) are assessed through an objective structured clinical examination (OSCE). This is part of the examinations which at the MHH represent the equivalent to the First Part of the Medical Examinations. The second year doctor-patient communication course preparing for these examinations was evaluated during the 2009/10 academic year.Using questionnaires specific to the learning objectives, learning needs were assessed, pre-post comparisons of self-assessed competencies were performed and key teaching methods were evaluated (5-point Likert scales, "5"=fully agree). At T0 (start of the course) 267 students participated (response rate: 93.7%), of which 180 filled out the T1 questionnaire during the last session of the course (67.4%). Within-subject analyses of variance and paired t-tests were conducted.The highest learning needs were found for the "to show how"-items regarding history taking and disclosing diagnoses (M=4.4). The T1-T0 comparisons showed the greatest improvements for history taking ("to know how": mean difference = +1.7, "to show how": +1.8, p<.0001 as with all tests) and the "to know how"-item regarding the disclosure of diagnoses (+1.6), followed by the "to show how"-items on disclosing a diagnosis (+1.4), shared decision making (+1.2), self-assessing one's own strengths/weaknesses (+1.0) and confidently approaching new patients (+0.7). Students with T0 values of 1 or 2 on the respective scales improved on average by 2.2 points across all items, students with the value of 3 by 1.1, and from 4 or 5 by 0.1. Methodically, the use of simulated patients was rated the most helpful (M=4.8, 87% with the scale value 5). This doctor-patient communication course is associated with substantial improvements regarding all key learning objectives. Regarding methods, the deployed simulated patients (2-4 per 10-student-course group in 3 of the 7 course sessions, respectively) were rated the most helpful. The present evaluation calls for both further development of the doctor-patient communication curriculum at the MHH and joint activities across medical schools, which are discussed at the end of the paper.

Project description:Objectives: Training communication skills has come to be recognized as a vital aspect of medical school education. A medical communication course based on the COMSKIL Communication Skills Training (CST) Program was developed, integrated into the core curriculum, and evaluated at the Leipzig University Medical School. Methods: Between October 2016 and July 2017, 312 medical students (mean age 21.80 years; 62% male) participated in the medical communication course. Each course unit was evaluated via questionnaires specifically designed to address the theoretical and practical content of the curriculum. The items correspond to the material covered in each course unit. Students responded using a 5-point-Likert scale (1="not at all helpful", 5="extremely helpful") to rate the degree to which the course helped them learn about the subject matter and train the skills covered in the curriculum. Results: The average score for the first part of the course (theoretical foundations) was M=3.69 (SD=0.35). The second part received a similar rating (M=3.84; SD=0.73). The role play exercises with actor-patients received a score of M=4.27 (SD=0.62). In an overall evaluation at the end of the course, students rated the administration of the course (setting, etc), knowledge gained, and skills trained with a score of M=4.11 (SD=0.66). The role play exercises received an overall score of M=4.36 (SD=0.61). Conclusion: A new curriculum for teaching medical students patient-physician communication skills based on the COMSKIL CST program was established at the University of Leipzig. The goal of this course is to teach students about the kinds of communication scenarios they will encounter in their future working lives as care providers and equip them with the fundamental communication techniques and skills they need to successfully handle those situations. A formal evaluation of the program resulted in satisfactory findings, indicating that it is well suited for use in medical universities.

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Teaching Pediatric Palliative Care Communication Skills to Fourth-Year Medical Students Through Role-Play.

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Teaching Pediatric Palliative Care Communication Skills to Fourth-Year Medical Students Through Role-Play.

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