Neo Shirlyn Hui Shan, Zhou Jamie X, Wong Genevieve C, Mok Natalie K, Yee Alethea C, Phua Gillian L
Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, SGP.
Department of Social Work Services, National Heart Centre Singapore, Singapore, SGP.
Cureus. 2021 Nov 28;13(11):e19957. doi: 10.7759/cureus.19957. eCollection 2021 Nov.
Background Patients with advanced cardiac conditions value effective symptom control and empathic communication with their doctors. However, studies have shown that empathic communication with seriously ill patients does not occur adequately in cardiology. Therefore, we piloted a program for teaching communication skills in a bite-sized manner. The primary aim of the research was to understand the feasibility and acceptability of the training program and to perform a preliminary evaluation of its efficacy. Methodology Clinicians were recruited from the cardiology unit of a tertiary hospital in Singapore. Patients were also recruited for the audio recording of clinic consults. Recruited patients had to have a chronic cardiac condition and be deemed at risk of dying within one year. We utilized a pre-post intervention design. Prior to the educational intervention, clinicians were asked to audio record a single clinic consult at baseline. They were then asked to participate in a training program that consisted of video-annotated presentations and role-play scenarios. Subsequently, the audio recordings of their clinic consults with seriously ill patients were recorded. The audio recordings were evaluated by trainers and used for feedback with clinicians. Data on the completion rate of the training program were collected. In addition, changes in the clinicians' self-rated communication skills and views on the acceptability and relevance of the training program were collected. Results Overall, five of the six clinicians (83.3%) completed all sessions in the program. One clinician only completed four out of the five sessions in the program. Clinicians deemed the program acceptable and relevant and found audio recordings to be useful for reflective learning. There was an improvement in the clinicians' self-assessed competency. However, the planned number of audio recordings could not be completed due to the coronavirus disease 2019 pandemic. Conclusions The pilot training program was acceptable and relevant for the participants. However, it will require adaptation to allow it to be transferrable and scalable to all settings, especially in situations that limit prolonged face-to-face contact.
背景 患有晚期心脏疾病的患者重视有效的症状控制以及与医生的共情沟通。然而，研究表明，在心脏病学领域，与重症患者的共情沟通并不充分。因此，我们试点了一个以简短形式教授沟通技巧的项目。该研究的主要目的是了解培训项目的可行性和可接受性，并对其效果进行初步评估。方法 从新加坡一家三级医院的心脏病科招募临床医生。还招募患者进行门诊咨询的音频录制。招募的患者必须患有慢性心脏病，且被认为在一年内有死亡风险。我们采用了干预前-干预后设计。在教育干预之前，要求临床医生在基线时对一次门诊咨询进行音频录制。然后，他们被要求参加一个由视频注释演示和角色扮演场景组成的培训项目。随后，记录他们与重症患者门诊咨询的音频。培训师对音频记录进行评估，并用于与临床医生的反馈。收集培训项目的完成率数据。此外，收集临床医生自我评估沟通技巧的变化以及对培训项目可接受性和相关性的看法。结果 总体而言，六名临床医生中有五名（83.3%）完成了项目的所有课程。一名临床医生只完成了项目五节课程中的四节。临床医生认为该项目可接受且相关，并发现音频记录对反思性学习有用。临床医生的自我评估能力有所提高。然而，由于2019年冠状病毒病大流行，未能完成计划的音频录制数量。结论 试点培训项目对参与者来说是可接受且相关的。然而，它需要进行调整，以便能够转移并扩大到所有环境，特别是在限制长时间面对面接触的情况下。
