Ronald O Perelman Department of Emergency Medicine and Population Health, New York University School of Medicine, New York, New York, USA.
Department of Critical Care Medicine and Emergency Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
BMJ Support Palliat Care. 2016 Jun;6(2):219-24. doi: 10.1136/bmjspcare-2015-000993. Epub 2016 Jan 12.
The emergency department visit for a patient with serious illness represents a sentinel event, signalling a change in the illness trajectory. By better understanding patient and family wishes, emergency physicians can reinforce advance care plans and ensure the hospital care provided matches the patient's values. Despite their importance in care at the end of life, emergency physicians have received little training on how to talk to seriously ill patients and their families about goals of care. To expand communication skills training to emergency medicine, we developed a programme to give emergency medicine physicians the ability to empathically deliver serious news and to talk about goals of care. We have built on lessons from prior studies to design an intervention employing the most effective pedagogical techniques, including the use of simulated patients/families, role-playing and small group learning with constructive feedback from master clinicians. Here, we describe our evidence-based communication skills training course EM Talk using simulation, reflective feedback and deliberate practice.
对于患有重病的患者来说,急诊科就诊是一个警戒事件,标志着疾病轨迹的变化。通过更好地了解患者和家属的意愿,急诊医生可以加强预先护理计划,并确保提供的医院护理符合患者的价值观。尽管在生命末期护理中非常重要,但急诊医生在如何与重病患者及其家属谈论护理目标方面接受的培训很少。为了将沟通技巧培训扩展到急诊医学领域,我们开发了一个计划,使急诊医生能够富有同理心的传达严重的消息,并讨论护理目标。我们借鉴了之前研究的经验,设计了一项干预措施,采用了最有效的教学技巧,包括使用模拟患者/家属、角色扮演和小组学习,并从资深临床医生那里获得建设性的反馈。在这里,我们使用模拟、反思性反馈和刻意练习来描述我们基于证据的沟通技巧培训课程 EM Talk。