Department of Cancer Education, Princess Margaret Cancer Centre, Toronto, Canada.
Patient Education, Cancer Care Ontario, Toronto, Canada.
J Cancer Educ. 2021 Oct;36(5):1030-1038. doi: 10.1007/s13187-020-01729-x.
Effective communication between healthcare providers (HCPs) and patients is important for HCP well-being, patient engagement, and health outcomes. Yet, HCPs do not receive adequate communication skills training and report feeling unprepared for difficult conversations. A needs assessment of 64 cancer HCP trainees in Toronto, Canada, found that a majority of trainees rated themselves with low competency in communication skills to support patients through difficult conversations, while nearly all rated these skills as important to their practice. A blended multiprofessional communications program was developed including online theoretical learning and reflective practice in addition to in-person simulation with standardised patient actors. Since communication skills mastery is highly unlikely to occur at the termination of a single training program, the goal of the program was to stimulate participants' motivational beliefs about difficult conversations communication skills in order to deepen their commitment to learning and mastery. The motivational beliefs assessed included self-efficacy (self-perceived competence), intent to use techniques learned, and confidence in task mastery. After completing the course, participants' self-perceived competence in dealing with difficult conversations significantly increased by an average of 25 points (p < 0.001) on a rating scale of 1-100 (n = 40). Participants' intent to use techniques did not change significantly and remained high with an overall average of 89 points. After the course, participants rated their confidence in mastering techniques learned at an average score of 71 points. Multiprofessional, simulation-based training is an effective way to improve HCP trainees' motivational beliefs around having difficult conversations.
医疗保健提供者(HCP)与患者之间的有效沟通对于 HCP 的幸福感、患者的参与度和健康结果都很重要。然而,HCP 并没有接受足够的沟通技巧培训,并且表示他们对困难对话感到准备不足。在加拿大多伦多对 64 名癌症 HCP 受训者进行的需求评估发现,大多数受训者认为自己在通过困难对话支持患者方面的沟通技巧能力较低,而几乎所有受训者都认为这些技能对他们的实践很重要。制定了一个混合的多专业沟通计划,包括在线理论学习和反思性实践,以及与标准化患者演员进行的面对面模拟。由于沟通技巧的掌握不太可能在单一培训计划结束时发生,因此该计划的目标是激发参与者对困难对话沟通技巧的动机信念,以加深他们对学习和掌握的承诺。评估的动机信念包括自我效能感(自我感知能力)、意图使用所学技术,以及对任务掌握的信心。完成课程后,参与者在处理困难对话方面的自我感知能力平均提高了 25 分(p<0.001),评分范围为 1-100(n=40)。参与者使用技术的意图没有显著变化,总体平均为 89 分。课程结束后,参与者对掌握所学技术的信心平均评分为 71 分。多专业、基于模拟的培训是提高 HCP 受训者进行困难对话的动机信念的有效方法。