Self-Assessment Scores Improve After Simulation-Based Palliative Care Communication Skill Workshops. (January 2018)

• Record Type: Journal Article
• Authors: Brown, Crystal E.; Back, Anthony L.; Ford, Dee W.; Kross, Erin K.; Downey, Lois; Shannon, Sarah E.; Curtis, J. Randall; Engelberg, Ruth A.
• Is Part Of: American journal of hospice & palliative care. Volume 35:Number 1(2018)
• Page Start: 45
• Page End: 51
• Publication Date: 2018-01
• Subjects: palliative care -- self-efficacy -- communication skills -- self-assessment -- end-of-life communication; Hospice care -- Periodicals; Palliative treatment -- Periodicals; 362.175
• DOI: 10.1177/1049909116681972
• Languages: English
• ISSNs: 1049-9091

Abstract

Background: We conducted a randomized trial of a simulation-based multisession workshop to improve palliative care communication skills (Codetalk). Standardized patient assessments demonstrated improved communication skills for trainees receiving the intervention; however, patient and family assessments failed to demonstrate improvement. This article reports findings from trainees' self-assessments. Aim: To examine whether Codetalk resulted in improved self-assessed communication competence by trainees. Design: Trainees were recruited from the University of Washington and the Medical University of South Carolina. Internal medicine residents, medicine subspecialty fellows, nurse practitioner students, or community-based advanced practice nurses were randomized to Codetalk, a simulation-based workshop, or usual education. The outcome measure was self-assessed competence discussing palliative care needs with patients and was assessed at the start and end of the academic year. We used robust linear regression models to predict self-assessed competency, both as a latent construct and as individual indicators, including randomization status and baseline self-assessed competency. Results: We randomized 472 trainees to the intervention (n = 232) or usual education (n = 240). The intervention was associated with an improvement in trainee's overall self-assessment of competence in communication skills ( P < .001). The intervention was also associated with an improvement in trainee self-assessments of 3 of the 4 skill-specific indicators—expressing empathy, discussing spiritual issues, and eliciting goals of care. Conclusion: Simulation-based communication training was associated with improved self-assessed competency in overall and specific communication skills in this randomized trial. Further research is needed to fully understand the importance and limitations of self-assessed competence in relation to other outcomes of improved communication skill.