(P40) Improving Communication Skills Amongst Clinicians Through Formal Evidence Based Training

Objective/Aim: To conduct a quality improvement project assessing whether training using the VitalTalk program will lead to improved knowledge, skills and attitudes on communicating with patients and families about serious illness.

Background: Empathic, honest communication between physicians and patients/families is the foundation of shared decision making and patient centered care. Only 14% of physicians report advance care planning discussions with patients and over 60% report they have never received formal training. Multiple models of training exist. VitalTalk provides evidence-based training using simulated patients to train clinicians to communicate effectively with seriously ill patients and their families.

Quality Improvement

Methods: All geriatricians (N=22) at the Queen’s University Medical Group and University of Hawaii received a 4-hour VitalTalk training session (July to September 2022) on Zoom, or participated in VitalTalk web-based training. After completion of training, geriatricians evaluated the workshop, and completed a retrospective pre-post survey related to their skills and comfort level with different communication skills. Additional resources from VitalTalk were provided after the training. Efficacy and incorporation of learned skills into practice will continue to be evaluated at 1 and 3-month follow-up. Data from baseline and 1-month follow-up were analyzed using descriptive statistics and paired t-tests, comparing differences between pre and post scores.

Results: All participants (100% response rate) completed the evaluations. Evaluation scores were rated on a 5-point Likert Scale: 1=poor, 5=excellent. Baseline mean scores on quality of training questions were high, ranging from 4.45 to 4.95. Using a retrospective pre-post questionnaire, there were significant improvements in skills in discussing clinical status (3.68 to 4.14, p=0.004), goals of care (3.73 to 4.18, p=0.0018) and advance care planning (3.82 to 4.23, p=0.0038). Results were similar in comfort levels in discussing these subjects. There were also significant improvements in self-assessment of communication skills across eight domains: assessment of patient knowledge (p=0.0004), giving a headline (p < 0.0001), responding to patient’s emotions (p=0.0002), aligning with patient’s hopes and sharing concerns (p=0.0002), managing uncertainty and conflict (p < 0.0001), promoting prognostic awareness (p=0.0018), eliciting patient’s goals and values (p=0.0038), and recommending treatment to support values (p=0.0106). At 1-month follow-up, 18/22 (82%) had used the skills gained from the training and continued to rate the training highly.

Conclusions: Communication skills are crucial for clinicians to provide patient centered care. Early results suggest that formal evidence-based training improves skills and comfort levels in communicating about serious illness with patients and families. We plan additional PDSA cycles to increase long-term use of these skills.