Ronald O. Perelman Department of Emergency Medicine, NYU Grossman School of Medicine, New York, 227 East 30thStreet, New York, NY, 10016, USA.
Department of Emergency Medicine, Mayo Clinic, Rochester, MN, USA.
BMC Palliat Care. 2024 Feb 21;23(1):48. doi: 10.1186/s12904-024-01349-y.
EM Talk is a communication skills training program designed to improve emergency providers' serious illness conversational skills. Using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework, this study aims to assess the reach of EM Talk and its effectiveness.
EM Talk consisted of one 4-h training session during which professional actors used role-plays and active learning to train providers to deliver serious/bad news, express empathy, explore patients' goals, and formulate care plans. After the training, emergency providers filled out an optional post-intervention survey, which included course reflections. Using a multi-method analytical approach, we analyzed the reach of the intervention quantitatively and the effectiveness of the intervention qualitatively using conceptual content analysis of open-ended responses.
A total of 879 out of 1,029 (85%) EM providers across 33 emergency departments completed the EM Talk training, with the training rate ranging from 63 to 100%. From the 326 reflections, we identified meaning units across the thematic domains of improved knowledge, attitude, and practice. The main subthemes across the three domains were the acquisition of Serious Illness (SI) communication skills, improved attitude toward engaging qualifying patients in SI conversations, and commitment to using these learned skills in clinical practice.
Our study showed the extensive reach and the effectiveness of the EM Talk training in improving SI conversation. EM Talk, therefore, can potentially improve emergency providers' knowledge, attitude, and practice of SI communication skills.
Clinicaltrials.gov: NCT03424109; Registered on January 30, 2018.
EM Talk 是一项旨在提高急救提供者处理重病沟通技巧的交流技能培训计划。本研究采用 Reach、Effectiveness、Adoption、Implementation 和 Maintenance（RE-AIM）框架，旨在评估 EM Talk 的覆盖范围及其效果。
EM Talk 包括一次 4 小时的培训课程，专业演员通过角色扮演和主动学习培训提供者传递严重/不良消息、表达同理心、探索患者目标以及制定护理计划。培训结束后，急救提供者填写了一份可选的干预后调查，其中包括课程反思。我们采用多方法分析方法，从定量上分析干预措施的覆盖范围，从定性上使用开放式回答的概念内容分析来分析干预措施的有效性。
共有 33 个急救部门的 1029 名 EM 提供者中的 879 名（85%）完成了 EM Talk 培训，培训率从 63%到 100%不等。从 326 次反思中，我们确定了贯穿主题领域的意义单位，包括知识、态度和实践的提高。三个领域的主要子主题包括获取严重疾病（SI）沟通技巧、提高与符合条件的患者进行 SI 对话的态度以及承诺在临床实践中使用这些所学技能。
我们的研究表明，EM Talk 培训在提高 SI 对话方面具有广泛的覆盖范围和有效性。因此，EM Talk 有可能提高急救提供者处理 SI 沟通技巧的知识、态度和实践。
Clinicaltrials.gov：NCT03424109；于 2018 年 1 月 30 日注册。
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