October Tessie W, Dizon Zoelle B, Hamilton Melinda F, Madrigal Vanessa N, Arnold Robert M
Division of Critical Care Medicine, Children's National Health Systems, Washington, District of Columbia, USA.
Department of Pediatrics, George Washington University School of Medicine, Washington, District of Columbia, USA.
Clin Teach. 2019 Jun;16(3):242-247. doi: 10.1111/tct.12927. Epub 2018 Aug 16.
Inter-specialty clinicians often co-lead family conferences for hospitalised patients. Families frequently report receiving different messages from different clinicians. We developed a communication training workshop that crosses disciplines and co-trains clinicians in one setting to create a culture of delivering a unified message.
We developed a 2-day paediatric communication skills workshop to teach the skills necessary to conduct a family conference. The workshop was targeted at nurse-practitioners and faculty clinicians representing the different specialties that co-manage children in an intensive care unit. Our primary outcomes were learner self-assessment of skills attainment and workshop satisfaction. We also evaluated the feasibility of recruiting busy clinicians.
Fifteen clinicians, including eight critical care faculty members (80% of eligible participants), three subspecialty faculty members (100% of eligible participants) and four nurse-practitioners (100% of eligible participants), participated. Learners' self-reported confidence improved in all communication metrics assessed. From pre- to post-workshop, confidence increased from 39% to 94% for 'giving bad news' (p < 0.05), from 50% to 83% for 'conducting a family conference' (p < 0.05), and from 39% to 100% for 'eliciting a family's values/preferences (p < 0.05). Every learner rated the workshop as important to their clinical practice and 100% would strongly recommend it to others. All reported the time commitment was not burdensome and 74% would choose this 2-day format over shorter formats. When clinicians learn together, they are more likely to speak the same language when communicating with each other, and ultimately to deliver the same message to families CONCLUSIONS: An inter-specialty communication training workshop for different types of clinician was well received. It is feasible to co-train different types of clinician in a joint session. When clinicians learn together, they are more likely to speak the same language when communicating with each other, and ultimately to deliver the same message to families.
跨专业的临床医生经常共同主持住院患者的家庭会议。家属经常报告称从不同的临床医生那里收到了不同的信息。我们开发了一个跨学科的沟通培训工作坊，在同一环境中对临床医生进行联合培训，以营造传递统一信息的文化氛围。
我们开发了一个为期两天的儿科沟通技巧工作坊，教授召开家庭会议所需的技能。该工作坊针对代表重症监护病房中共同管理儿童的不同专业的执业护士和临床教员。我们的主要成果是学习者对技能掌握情况的自我评估和工作坊满意度。我们还评估了招募忙碌临床医生的可行性。
15名临床医生参加了培训，其中包括8名重症监护教员（占符合条件参与者的80%）、3名亚专业教员（占符合条件参与者的100%）和4名执业护士（占符合条件参与者的100%）。在所有评估的沟通指标中，学习者自我报告的信心都有所提高。从工作坊前到工作坊后，“告知坏消息”的信心从39%提高到94%（p<0.05），“召开家庭会议”的信心从50%提高到83%（p<0.05），“引出家庭价值观/偏好”的信心从39%提高到100%（p<0.05）。每位学习者都认为该工作坊对他们的临床实践很重要，100%的人会强烈推荐给其他人。所有人都表示时间投入并不繁重，74%的人会选择这种为期两天的形式而不是更短的形式。当临床医生一起学习时，他们在相互交流时更有可能使用相同的语言，最终向家属传达相同的信息。
针对不同类型临床医生的跨专业沟通培训工作坊受到了好评。在联合课程中对不同类型的临床医生进行联合培训是可行的。当临床医生一起学习时，他们在相互交流时更有可能使用相同的语言，最终向家属传达相同的信息。
