Abstract
To describe the experience of the Italian Program to Enhance Relations and Communication Skills (PERCS-Italy) for difficult healthcare conversations. PERCS-Italy has been offered in two different hospitals in Milan since 2008. Each workshop lasts 5 h, enrolls 10–15 interdisciplinary participants, and is organized around simulations and debriefing of two difficult conversations. Before and after the workshops, participants rate their preparation, communication, relational skills, confidence, and anxiety on 5-point Likert scales. Usefulness, quality, and recommendation of the program are also assessed. Descriptive statistics, t-tests, repeated-measures ANOVA, and Chi-square were performed. A total of 72 workshops have been offered, involving 830 interdisciplinary participants. Participants reported improvements in all the dimensions (p < 0.001) without differences across the two hospitals. Nurses and other professionals reported a greater improvement in preparation, communication skills, and confidence, compared to physicians and psychosocial professionals. Usefulness, quality, and recommendation of PERCS programs were highly rated, without differences by discipline. PERCS-Italy proved to be adaptable to different hospital settings, public and private. After the workshops, clinicians reported improvements in self-reported competencies when facing difficult conversations. PERCS-Italy’s sustainability is based on the flexible format combined with a solid learner-centered approach. Future directions include implementation of booster sessions to maintain learning and the assessment of behavioral changes.
Highlights
Conveying difficult news to patients and families is a common occurrence in clinical practice
In 2008, following a period of collaboration between Boston Children’s Hospital and University of Milan, the Program to Enhance Relational and Communication Skills (PERCS) program was adapted to the Italian context and implemented at San Paolo Hospital, a public University hospital based in Milan [19]
Since 2016, the PERCS program has been offered at Humanitas University Hospital, a private hospital based in Milan
Summary
Conveying difficult news to patients and families is a common occurrence in clinical practice. Communicating the onset of chronic disease or death of a loved one, approaching families for organ donation, disclosing medical error, or communicating an implantation failure to an infertile couple are just some of the difficult conversations that clinicians may face in clinical practice. The manner in which these conversations are conducted can have long-lasting effects on patients and families [1]. Several studies report that communication skills and relational abilities of clinicians are associated with greater patient satisfaction and adherence [2], improved health outcomes [3], decreased bereavement burden [1], fewer malpractice claims [4], and greater positive attitude towards healthcare organizations [5]. Conducting difficult conversations requires clinicians to have a solid knowledge of communication theories and skills, and to. Sharing perspectives on “what works in difficult conversations . . . ” Didactic lecture
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