Communication Skills Training Program Research Articles

Communication skills training: a quantitative systematic review

Purpose Organizational leaders value effective communication in employees, but ineffective communication persists (Peart, 2019). Communication Skills Training (CST) programs often face time and engagement constraints (Wright et al., 2006), necessitating increased resources for improvement. This study investigates the fields in which communication skills are examined and the research methods used. Given past training-communication associations, it explores CST programs' positive impact through experimental research (Bakker & van Wingerden, 2021). The study aims to enhance CST research by providing insights into effective training methods for facilitators and practitioners. Design/methodology/approach This systematic literature review examines CST's effectiveness in improving employee communication outcomes and identifying key factors. It highlights the importance of communication training, provides insights into existing research, and identifies areas for future investigation. As communication training is not context-specific, a comprehensive understanding of its effectiveness is necessary. This review establishes a foundational framework to support the creation of impactful training programs. Findings This research reaffirms the importance of Communication Skills Training (CST) in enhancing key competencies such as communication competence, self-efficacy, and empathy for workplace success, benefiting collaboration, conflict resolution, and problem-solving. It provides a foundational understanding of CST's impact, serving as a resource for researchers, trainers, and leaders, while also emphasizing the need for further research, including larger experiments, diverse skill sets, and long-term assessment. In our digital age, exploring contemporary skills, including digital communication, is essential for comprehensive training. The systematic categorization of skills into intrapersonal and interactional dimensions ensures consistency and supports in-depth analysis. Originality/value To address the broad range, outcome skills were categorized as intrapersonal or interactional, excluding the behavioral aspect concerning societal improvement. Leveraging Zimmerman's (1995) empowerment theory to enhance focus, this framework provides value for diverse CST research outcomes. Intrapersonal encompassed self-views, like self-efficacy and knowledge, while interactional involved understanding and aligning exchanges with personal goals. This categorization enhances research clarity and effectiveness by systematically understanding how these skills are related.

Serious illness communication skills training for emergency physicians and advanced practice providers: a multi-method assessment of the reach and effectiveness of the intervention

BackgroundEM 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.MethodsEM 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.ResultsA 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.ConclusionOur 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.Trial registrationClinicaltrials.gov: NCT03424109; Registered on January 30, 2018.

Developing online communication training to request donation for vascularized composite allotransplantation (VCA): improving performance to match new US organ donation targets.

Approaching families of dying or newly deceased patients to donate organs requires specialized knowledge and a mastery of relational communication. As the transplantation field has progressed, Donation Professionals (DPs) are also leading conversations with family decision makers (FDMs) about the donation of uncommon anatomical gifts, such as face, hands, genitalia, referred to as Vascularized Composite Allotransplants (VCA) without much training or experience. To address the need for training, we adapted and beta tested an evidenced-based communication training program for donation discussions to VCA requests. The overarching goal of Communicating Effectively about Donation for Vascularized Composite Allotransplantation (CEaD-VCA) is to increase the number of VCA authorizations and to improve the socioemotional outcomes of FDMs. We developed CEaD-VCA, an online, on-demand training program based on the previously tested, evidenced-based communication skills training program designed to train DPs to have conversations about solid organ donation. The training was modified utilizing data from a national telephone survey with DPs and results of 6 focus groups conducted with members of the general public. The survey and focus groups assessed knowledge, attitudes, and barriers to VCA donation. The training was shaped by a partnership with a leading industry partner, the Gift of Life Institute.™ RESULTS: Using the results as a guide, the existing CEaD training program, consisting of interactive eLearning modules, was adapted to include technical information about VCA, foundational communication skills, and two interactive example VCA donation request scenarios to facilitate active learning. Forty-two DPs from two partner Organ Procurement Organizations (OPOs) participated in the beta test of CEaD-VCA. Pre- and post-test surveys assessed the impact of the training. The training was scored highly by DPs in effectiveness and ease of use. This project created a standardized, accessible, and comprehensive training for DPs to communicate about VCA donation. CEaD-VCA is an example of how to develop a communication skills training for difficult conversations utilizing input from stakeholders, guided by communication theory. It also demonstrates how gaps in communication skills during medical education can be filled utilizing advanced online Learning Management Systems. The training specifically addresses new CMS rules concerning OPO performance metrics.

Communication, Cognition and Competency Development in Healthcare: A Model for Integrating Cognitive Ethnography and Communication Skills Training in Clinical Interventions.

The aim of this study was to conduct and evaluate the Blended Learning communication skills training program. The key objective was to investigate (i) how clinical intervention studies can be designed to include cognitive, organizational, and interactive processes, and (ii) how researchers and practitioners could work with integrated methods to support the desired change. The method combined design and implementation of a 12-week Blended Learning communication skills training program based on the Calgary-Cambridge Guide. The training was implemented in a patient clinic at a Danish university hospital and targeted all healthcare professionals at the clinic. Cognitive ethnography was used to document and evaluate healthcare professionals' implementation and individual competency development, and support the design of in-situ simulation training scenarios. Thirteen participants completed the program. The synergy within the teams, as well as the opportunities for participants to coordinate, share, discuss, and reflect on the received knowledge with a colleague or on-site researcher, affected learning positively. The knowledge transfer process was affected by negative feedback loops, such as time shortages, issues with concept development and transfer, disjuncture between the expectations of participants and instructors of the overall course structure, as well as participant insecurity and a gradual loss of motivation and compliance. We propose a novel 3-step model for clinical interventions based on our findings and literature review. This model will effectively support the implementation of educational interventions in health care by narrowing the theory-practice gap. It will also stimulate desired change in individual behavior and organizational culture over time. Furthermore, it will work for the benefit of the clinic and may be more suitable for the implementation of communication projects than, for example, randomized setups.

Integrating medical and practical skills in communication skills training: Do students feel it supports them with transfer from classroom to practice?

To describe innovations in a clinical communication skills training (CCST) program, aimed at facilitating transfer of communication skills from classroom to clinical practice and report student's evaluations regarding this program. To facilitate transfer, we integrated CCS with medical and practical skills, and we developed simulation sessions closely resembling clinical practice in case-history's, length of consultation, and patient-population. Feedback was given on communication skills and medical knowledge and skills. Student's opinions about whether these elements were helpful, were evaluated using a questionnaire. Responses of 144 students were analyzed. The majority of the respondents agreed that this CCST program helped them with transfer of CCS from classroom to clinical practice, as did the feedback on medical content and communication skills in the same session. Students indicate that simulations resembling clinical practice and feedback on both CST and medical content facilitate the transfer of their skills to clinical practice. This CCST program is innovative because it integrates medical and practical skills, with elements aiming to create an educational environment resembling clinical practice as closely as possible in order to facilitate transfer to clinical practice.

Evaluating feasibility and acceptability of an innovative personalized hybrid longitudinal communication skills training program.

428 Background: Effective patient-physician communication plays a vital role in providing care. Improved patient satisfaction and reduced burnout are among the many benefits of effective communication. Medical training in this area through didactic lectures, group discussions, and role play with feedback can facilitate better acquisition and honing of communication skills. We aimed to create a longitudinal training program assisting residents in developing communication skills. Methods: Internal Medicine (IM) residents participated in a 6-month project as part of their training. Residents completed a baseline questionnaire to assess confidence in communication skills, followed by a curriculum comprised of 3 x 1-hour sessions every 5 weeks where expert lecturers guided didactics on pertinent topics (e.g., delivering bad news, discussing goals of care (GOC), and completing a Practitioner Orders for Life-Sustaining Treatment (POLST)). Participants completed post-session surveys after each training, and a comprehensive post-training self-assessment. Comfort level was assessed on a 1-5 scale (1 least comfortable, 5 most comfortable) throughout the surveys. Results: Pre-intervention, most residents utilized “Ask, Tell, Ask (ATA)” (46.67%) and “Setting, Perception, Invitation, Knowledge, Emotion, Summarize (SPIKES)” (40%) frameworks to facilitate conversations with patients. Post-intervention, a greater number of residents utilized SPIKES (52.08%) compared to ATA (37.5%). 1st (PGY1) and 2nd (PGY2) year residents reported completing +25.71% and +60% more POLST forms post-intervention. In the inpatient (IP) setting, resident comfort levels in initiating GOC increased by +15.8% (for PGY1s) and +6.7% in total (all classes). Comfort levels in breaking bad news to patients in the IP setting increased by +9.09% (+24.14% for PGY1s specifically). PGY2s had the most substantial increase in comfort level in completing POLST forms (+21.08% IP, +31.52% outpatient (OP)), with an overall improvement in comfort from all classes of +12.32% (IP) and 12.53% (OP) post-intervention. Conclusions: This curriculum represents a helpful tool to improve physician-patient communication among IM residents. PGY1s demonstrated the most substantial improvement in confidence following the program, which may indicate the importance of prioritizing training for first year residents. Qualitative feedback from residents included distributing sessions throughout the year (beginning, middle, end), holding sessions in the intensive care unit (ICU) for applicability to patients in real-time, and continued instruction of practical skills. These findings may allow for future curriculum planning to help bolster trainee confidence and skills when facilitating meaningful conversations with their patients.

Integrating evidence-based communication principles into routinecancer care.

The global incidence of cancer and available cancer-directed therapy options is increasing rapidly, presenting patients and clinicians with more complex treatment decisions than ever before. Despite the dissemination of evidence-based communication training tools and programs, clinicians cite barriers to employing effective communication in cancer care (e.g., discomfort of sharing serious news, concern about resource constraints to meet stated needs). We present two composite cases with significant communication challenges to guide clinicians through an application of evidence-based approaches to achieve quality communication. Composite cases, communication skills blueprint, and visual conceptualization. High-stakes circumstances in each case are described, including end-of-life planning, advanced pediatric illness, strong emotions, and health inequities. Three overarching communication approaches are discussed: (1) content selection and delivery; (2) rapport development; and (3) empathic connection. The key takeaways following each case provide succinct summaries of challenges encountered and approaches used. A communication blueprint from the Memorial Sloan Kettering Cancer Center Communication Skills Training Program and Research Laboratory has been adapted and is comprised of strategies, skills, process tasks, andsample talking points. A visually concise tool - the Communication Blueprint Traffic Circle - illustrates these concepts and demonstrates the iterative, holistic, and agile considerations inherent to effective communication. Evidence-based communication is foundational to person-centeredness, associated with improved clinician and patient/caregiver outcomes, and can be integrated throughout routineoncology care. When used by clinicians, evidence-based communication can improve patient and caregiver experiences and assist in ensuring goal-concordant cancer care delivery.

Geriatric Communication Skills Training Program for Oncology Healthcare Providers: a Secondary Analysis of Patient and Caregiver Outcomes.

Geriatric cancer patients and their caregivers have unique needs that make it difficult for their healthcare providers (HCPs) to effectively communicate with them. As ineffective communication can lead to negative health outcomes, it is important that oncology HCPs receive specialized training on communication with older adult patients and their caregivers. We conducted a small pilot study examining audio recordings of clinical encounters between HCPs and older adult cancer patients/caregivers and questionnaires completed by the patients and their caregivers before and after the HCPs participated in a geriatric communication skills training program. Eleven HCPs completed the 6-h Geriatric Comskil Training. Two clinic consultations with unique geriatric patients (n = 44) and their caregivers (n = 29) were recorded before and after training and coded for HCPs' use of communication skills. Patients and caregivers also completed surveys measuring their satisfaction with HCP communication and perceived empathy. Analysis of the audio recordings revealed that HCPs did not increase their use of communication skills after training. Although our sample was too small to detect statistical significance, measures of effect size showed trending improvements in patients' and caregivers' perceptions of HCPs' empathy and satisfaction with their communication after training. Our findings build on previous studies evaluating the feasibility and effectiveness of the Geriatric Comskil Training in real world setting and indicate that the training may have improved HCPs' communication with older adult patients and their caregivers even if their use of their observable communication skills did not change.

Impact of a training program on hospital pharmacists' patient-centered communication attitudes and behaviors

BackgroundEffective communication that integrates the value of patient-centered care is important in healthcare encounters. Communication skills training (CST) has been indicated as effective in improving patient-centered communication behaviors. However, there is a paucity of studies on the impact of CST among Malaysian hospital pharmacists. ObjectiveThis study aimed to evaluate the effects of a patient-centered CST program on patient-centered communication scores, communication self-efficacy, and attitudes toward concordance among pharmacists in public hospitals. MethodsA communication skills training (CST) program was conducted among hospital pharmacists. This training intervention was developed based on patient-centered communication frameworks and techniques, namely the Four Habits Model and motivational interviewing. A pre-test/post-test quasi-experimental design was implemented for the evaluation. Pharmacists underwent pre-test/post-test audiotaped simulated consultations and completed questionnaires, including the Revised United States–Leeds Attitudes Toward Concordance scale (RUS-LATCon) and Communication Self-Efficacy scale. The Four Habits Coding Scheme (FHCS) was used to evaluate patient-centered communication scores from the audiotapes, and the Wilcoxon signed-rank test was used to analyze for differences in the pre- and post-intervention scores. ResultsA total of 38 pharmacists from four tertiary hospitals participated in this study and completed the pre-test. However, due to the impact of COVID-19, only 23 pharmacists completed the post-test data collection. Improvements were noted in the FHCS scores post-training, including items related to exploring patients' concerns, acceptability, and barriers to treatment. Based on the questionnaire, there was an improvement in recognizing patients' needs and potential medication uncertainty and an increase in the overall communication self-efficacy scores after the training. ConclusionsCST may help improve the adoption of patient-centered communication in pharmacists' consultations with patients.

ADCC's Improving Goal Concordant Care Initiative: Implementing Primary Palliative Care Principles.

High-quality, timely goals of care communication (GOCC) may improve patient and caregiver outcomes and promote care that is consistent with patient preferences. Cancer patients, and their loved ones, appreciate GOCC; however, oncologists often lack formal communication training, institutional support and structures necessary to promote the delivery, documentation, and longitudinal follow-up of GOCC. The Alliance of Dedicated Cancer Centers (ADCC), representing 10 U.S. academic cancer hospitals, undertook the Improving Goal Concordant Care Initiative (IGCC). This national, 3-year implementation initiative was designed in Fall 2019 by a workgroup of quality, oncology, and palliative care leaders, as well as patient and family advisory committee members (PFAC). IGCC addresses systemic gaps by requiring four core components for participation: 1) Implementation of a formal communication skills training (CST) program, 2) Structured GOCC documentation in the electronic medical record that is visible to all clinicians, 3) Expectations regarding the timing and patient populations for GOCC, and 4) Implementation of a measurement framework. Dyads of palliative and oncology leaders committed to attend regularly scheduled, ADCC-led, virtual meetings during the design and implementation phase, incorporating PFAC feedback at every stage. Using the RE-AIM framework, we describe process and outcome evaluation measures defined by implementation and measures workgroups and collected routinely, including: CST completion; trainee evaluation response rate, trainee-reported quality of CST, trainee changes in self-efficacy and distress; percent of high-priority patients participating in GOCC, and patient-reported response to the "Heard and Understood" scale (HU). IGCC's impact will be assessed using claims-based utilization metrics near the end of life (EOLM) and followed longitudinally. Qualitative evaluations near the completion of IGCC will provide insight into perceived barriers, enabling factors, and sustainability. Implementation of all IGCC components has begun at all sites. ADCC-wide, 35% of MD/DOs have completed CST (range by site: 8%-100%). CST is highly rated; in Quarter 3, 2022, 93%-100%, 90%-100% and 87%-100% of respondents reported above average to excellent CST quality, likelihood to use the skills and likelihood to recommend CST to others, respectively. Clinician self-efficacy and distress ratings are expected in late 2023. All sites have identified patient populations and continue to refine automated triggers and timelines; uptake of GOCC documentation has been slow. Eight of 10 sites have submitted patient-reported HU data. EOLM data are expected for all sites in early 2024. Flexibility in implementation with shared definitions, measures, and learnings about approaches optimizes the ability of all centers to collaborate and make progress in improving GOCC. Flexibility adds to the complexity of understanding intervention effectiveness, the critical intervention components and the fidelity necessary to achieve specific outcomes.

Communication: A Basic Skill of Medical Practice

The doctor-patient relationship is central to the practice of medicine and is essential for the delivery of high-quality healthcare in the diagnosis and treatment of disease. There is utmost need for effective communication in medical practice. Communication is the key that unlocks a number of benefits. It leads to increased patient satisfaction, better understanding of the treatment, improved compliance, and overall better health. Therefore, clearer communication better understanding, and thus, better outcomes in the patients’ and attendants’ satisfaction. The need for communication with patients should be emphasized as it helps patients feel at ease, reduces their anxiety and builds their confidence, makes patients/clients feel valued, and reduces the chances of medical errors. Some of the key barriers to effective communication are such as personal barriers: negative attitude by doctors towards communication and giving it a low priority due to their concern primarily to treat illness rather than focus on patients’ other needs which may be psychological or related to social wellbeing. Human failings, such as tiredness and stress: A lack of inclination to communicate with patients. This can be due to lack of time, uncomfortable topics, lack of confidence and concerns relating to confidentiality. Inconsistency in providing information and giving conflicting information by different healthcare providers. Organizational barriers, lack of time, pressure of work being subjected to interruptions. If the complains are justified it is important that you apologize and ask the relatives what they would like to be done about it. Any problem that the family feels or experience should be actively identified and appropriate action should be taken to resolve them. If their demanding behavior continues, set the limit and you can tell them that you cannot do better than what is being done. If the relatives insist on continuing to disagree about the patient’s management, it may be necessary to call some senior doctor to try to explain and convince them. Imparting bad news is an emotional experience for the doctor as well as the patient and requires additional targeted strategies. When you speak to the patient they get the chance to clarify their doubts. Medical schools/ Colleges must be encouraged to provide the best possible communication skills training as part of the core undergraduate curriculum. This training should have set objectives and clear methods of assessment. More communication skills training programs should be developed at post graduate level. Doctors should use the appraisal process as a vehicle for discussing the success of communication skills training. Bangladesh J Medicine 2023; Vol. 34, No. 2(1) Supplement: 178

What Impact Does Participation in a Communication Skills Training Program Have on Health Professionals’ Communication Behaviors: Findings from a Qualitative Study

Communication skills training can enhance health professionals’ knowledge and repertoire of effective communication practices. This paper describes the conceptual model underlying a 3-day retreat communication skills training program, methods used for training, and participant perception of outcomes from the training using qualitative interviews. Repeated qualitative telephone interviews (approximately 6 months apart) with participants of a 3-day Clinical Consultation Skills Retreat. Fourteen participants (70% response, 57% doctors) took part at Time 1, with 12 participating at Time 2. Semi-structured interviews were recorded and transcribed, and directional content analysis was conducted to assess themes in areas of key learnings, implementation of skills, and barriers. The training was received very positively with participants valuing the small group learning, role play, and facilitator skills. Key learnings were grouped into two themes: (i) tips and strategies to use in clinical practice and (ii) communication frameworks/methods, with the second theme reflecting an awareness of different communication styles. Most participants had tried to implement their new skills, with implementation reported as a more deliberate activity at T1 than at T2. Those implementing the new skills noted more open conversations with patients. Practical barriers of lack of time and expectations of others were mentioned more often at T2. A 3-day retreat-based communication training program was positively received and had a positive impact on the use of new communication skills. While further work is needed to determine whether effects of training are evidenced in objective clinical behaviors, the positive longer-term benefits found suggest this work would be worthwhile.

Development of an Online Communication Skills Training Program for Oncologists Working with Adolescents and Young Adults.

There are two purposes to this study. The first purpose was to develop a communication skills training (CST) program for oncologists working with adolescents and young adults (AYA-CST). The second purpose was to evaluate the program's feasibility. The online AYA-CST program was a half-day workshop including a didactic lecture, role-playing with simulated patients and discussions in a small group. All six oncologists who participated in the program satisfactorily completed it. Our AYA-CST program seems feasible and will be tested further in a randomized control study.

Facilitators and Barriers to a Hospital-Based Communication Skills Training Programme: An Interview Study.

This study aimed to investigate the facilitators and barriers experienced by the department management (DMs) and communication skills trainers (trainers) during the implementation of a 3-day communication skills training (CST) programme for healthcare professionals (HCPs). Thus, we conducted semi-structured interviews with 23 DMs and 10 trainers from 11 departments concurrently implementing the CST programme. Thematic analysis was undertaken to elucidate the themes across the interviews. Five themes were developed: resource consumption; obstacles; management support; efforts and outcomes; and a lack of systematic follow-up. Although the DMs and trainers were largely in agreement, the theme of a lack of systematic follow-up was derived exclusively from the trainers, as were two of the subthemes within obstacles: (b) seniority, profession, and cultural differences, and (c) the trainers' competencies. The greatest perceived barrier was resource consumption. In addition, DMs found planning and staff resistance to be a challenge. However, the HCPs' resistance diminished or even changed to satisfaction after participating. The mandatory approach served as both a facilitator and a barrier; DMs' support was an essential facilitator. Explicit communication related to resource demands, planning, and participation is crucial, as is management support and the allocation of resources.

Testing the Structural Equation of Organizational Culture Modelling as a Moderating as a Moderator of Public Service

Is study aims to examine the influence of Leadership Style, Strategic Orientation and Organizational Resources on Organizational Performance through Organizational Culture. This research was the first study to examine the influence of Leadership Style, Strategic Orientation and Organizational Resources on Organizational Performance through Organizational Culture conducted at Community Health Center. The model proposed in this study was carried out through structural equation modeling. Data were collected from a sample of 250 Community Health Center in DKI Jakarta Province. Data analysis was performed using SPSS 25 and SEM AMOS 24. The findings of this study provide several practical implications. First, Directors of Community Health Center are advised to take leadership training programs, such as public speaking & effective communication skill training program and coaching skill training program. Second, it requires entrepreneurship skill training program and risk management training program. Third, Directors of Community Health Center are advised to create programs to improve employee competence and increase the role of health leaders, as well as investment and adaptability to current technological developments in order to create resource efficiency and optimize the achievement of Community Health Center’s performance.
 Keywords: Culture modelling; SEM AMOS 24; performance

Effect of communication skills training on documentation of shared decision-making for patients with life-limiting illness: An observational study in an intensive care unit

ObjectivesThis article aims to examine the association between a shared decision-making (SDM) clinical communication training program and documentation of SDM for patients with life-limiting illness (LLI) admitted to intensive care. MethodsThis article used a prospective, longitudinal observational study in a tertiary intensive care unit (ICU). Outcomes included the proportion of patients with SDM documented on an institutional Goals of Care Form during hospital admission, as well as characteristics, outcomes, and factors associated with an SDM admission. InterventionClinical communication skills training (iValidate) and clinical support program are the intervention for this study. ResultsA total of 325 patients with LLI were admitted to the ICU and included in the study. Overall, 184 (57%) had an SDM admission, with 79% of Goals of Care Form completed by an iValidate-trained doctor. Exposure to an iValidate-trained doctor was the strongest predictor of an ICU patient with LLI having an SDM admission (odds ratio: 22.72, 95% confidence interval: 11.91–43.54, p < 0.0001). A higher proportion of patients with an SDM admission selected high-dependency unit–level care (29% vs. 12%, p < 0.001) and ward-based care (36% vs. 5%, p < 0.0001), with no difference in the proportion of patients choosing intensive care or palliative care. The proportion of patients with no deterioration plan was higher in the non-SDM admission cohort (59% vs. 0%, p < 0.0001). ConclusionsClinical communication training that explicitly teaches identification of patient values is associated with improved documentation of SDM for critically ill patients with LLI. Understanding the relationship between improved SDM and patient, family, and clinical outcomes requires appropriately designed high-quality trials randomised at the patient or cluster level.

Effect of multimodal comprehensive communication skills training with video analysis by artificial intelligence for physicians on acute geriatric care: a mixed-methods study

ObjectivesTo quantitatively analyse by artificial intelligence (AI) the communication skills of physicians in an acute care hospital for geriatric care following a multimodal comprehensive care communication skills training programme and...

Communication skills training for improving the communicative abilities of student social workers.

Good communication is central to effective social work practice, helping to develop constructive working relationships and improve the outcomes of people in receipt of social work services. There is strong consensus that the teaching and learning of communication skills for social work students is an essential component of social work qualifying courses. However, the variation in communication skills training and its components is significant. There is a sizeable body of evidence relating to communication skills training therefore a review of the findings helps to clarify what we know about this important topic in social work education. We conducted this systematic review to determine whether communication skills training for social work students works and which types of communication skills training, if any, were more effective and lead to the most positive outcomes. This systematic review aimed to critically evaluate all studies which have investigated the effectiveness of communication skills training programmes for social work students. The research question which the review posed is: 'What is the effectiveness of communication skills training for improving the communicative abilities of social work students?' It was intended that the review would provide a robust evaluation of communication skills training for social work students and help explain variations in practice to support educators and policy-makers to make evidence-based decisions in social work education, practice and policy. We conducted a search for published and unpublished studies using a comprehensive search strategy that included multiple electronic databases, research registers, grey literature sources, and reference lists of prior reviews and relevant studies. Study selection was based on the following characteristics: Participants were social work students on generic (as opposed to client specific) qualifying courses; Interventions included any form of communication skills training; eligible studies were required to have an appropriate comparator such as no intervention or an alternative intervention; and outcomes included changes in knowledge, attitudes, skills and behaviours. Study selection was not restricted by geography, language, publication date or publication type. The search strategy was developed using the terms featuring in existing knowledge and practice reviews and in consultation with social work researchers, academics and the review advisory panel, to ensure that a broad range of terminology was included. One reviewer conducted the database searches, removing duplicates and irrelevant records, after which each record was screened by title and abstract by both reviewers to ensure robustness. Any studies deemed to be potentially eligible were retrieved in full text and screened by both reviewers. Fifteen studies met the inclusion criteria. Overall, findings indicate that communication skills training including empathy can be learnt, and that the systematic training of social work students results in some identifiable improvements in their communication skills. However, the evidence is dated, methodological rigour is weak, risk of bias is moderate to high/serious or incomplete, and extreme heterogeneity exists between the primary studies and the interventions they evaluated. As a result, data from the included studies were incomplete, inconsistent, and lacked validity, limiting the findings of this review, whilst identifying that further research is required. This review aimed to examine effects of communication skills training on a range of outcomes in social work education. With the exception of skill acquisition, there was insufficient evidence available to offer firm conclusions on other outcomes. For social work educators, our understanding of how communication skills and empathy are taught and learnt remain limited, due to a lack of empirical research and comprehensive discussion. Despite the limitations and variations in educational culture, the findings are still useful, and suggest that communication skills training is likely to be beneficial. One important implication for practice appears to be that the teaching and learning of communication skills in social work education should provide opportunities for students to practice skills in a simulated (or real) environment. For researchers, it is clear that further rigorous research is required. This should include using validated research measures, using research designs which include appropriate counterfactuals, alongside more careful and consistent reporting. The development of the theoretical underpinnings of the interventions used for the teaching and learning of communication skills in social work education is another area that researchers should address.

Talking about death and dying: A delicate balance between the physician, patient, and their family caregivers

We thank the authors, Shah and Tiwari, for their evocative paper on passive euthanasia within the Indian healthcare setup.[1] The paper contributes to the larger discourse on the ethical dilemma of the right to die with human dignity. It highlights the need to initiate a dialogue within the Indian healthcare system regarding the introduction of communication skills for physicians and the practice of seeking healthy (and legal) consent when providing a diagnosis to the patient and their caregivers. This grants them the agency to actively participate in determining the quality of both their life and death. To ease the dilemma, the Indian Council of Medical Research Expert Group on “Do Not Attempt Resuscitation” (DNAR or passive euthanasia) highlighted the importance of open communication between the physicians and the patient/family caregivers to enhance the decision-making process.[2] In order to encourage open communication among the triad (patients, family caregivers, and their physicians) involved in illness communication in the Indian medical setting, it is necessary to recognize two unique aspects. First, India being a collectivist society, the agency and responsibility of the patient, especially in the case of terminal illness, are primarily vested with the family caregivers. This often overshadows the patients’ agency and role in the decision-making about their own bodies.[3] The vulnerable state of the patients renders them dependent on their family caregivers, who act as consent providers in treatment and medical decisions.[4] Despite their need for information regarding their illness and treatment, the patients play a passive role in illness communication and decision-making. Acknowledging the narratives of the authors of the current paper, research suggests that to provide consent for medical decisions, family caregivers have to engage in pragmatic questioning.[1,4] Often the family caregivers are forced to make a choice between the patient’s quality of life or continuing medical care. This dilemma results in feelings of guilt among the family caregivers. It is therefore crucial to recognize and involve the family caregivers in end-of-life decision-making and interventions. Second, patients and their caregivers in India prefer that their physicians initiate illness and treatment discussions.[4] Therefore, it is essential for physicians to lead discussions on DNAR/end-of-life. However, medical education in India does not offer training for communication skills as part of the curriculum.[5] The ramifications of not offering such training programs are also hinted at in the current paper, wherein physicians expressed fear and hesitancy to initiate conversations about DNAR with patients and caregivers.[1] It is imperative that a communication skills training program be included for physicians to focus on breaking bad news and open dialogue to having end-of-life conversations.[6] Further, cultural sensitivity needs to be incorporated while developing end-of-life interventions for patients.[7,8] To this end, we believe that achieving dignity in death is a process that begins with initiating sensitive conversations from the physician’s end. Furthermore, open and collaborative communication between the patient, physician, and family caregivers is required to ensure an ongoing dialogue on end-of-life care. This may help normalize conversations on death with dignity, bearing in mind the unique challenges of the Indian medical setting. Financial support and sponsorship The third author, Matsungshila Pongener, is funded by the Ministry of Education, Government of India. Conflicts of interest There are no conflicts of interest.

The Effects Of Communication Skills Education On Cognitive Flexibility And Communication Skills Of Adults

The aim of this study is to examine the The Effect of Rational Emotional Behavioral Approach Based Communication Skills Program on adults communication skills and cognitive flexibility levels. The participants of the study, which was designed according to the experimental design with the pre-test post-test control group, were included in the study randomly among the employees of an international hotel chain operating in Turkey. There are 5 female and 6 male members in the experimental group and 6 female and 5 male members in the control group. The data of the study were collected with the Cognitive Flexibility Inventory (CFI), Communication Skills Scale-Adult Form (CSS-AF) and Personal Information Form. Within the scope of the research, the Rational Emotional Behavioral Approach-Based Communication Skills Training Program (REBA-CSTP), developed by the researchers and consisting of 90 minutes and 12 sessions, was applied to the individuals in the experimental group. No application was made to the control group. Follow-up measurements were made four weeks after administration of the post-test. Research data were analysed in SPSS 24.0 environment, differences between groups were analysed with Mann-Whitney U and Wilcoxon Signed Rank Test. As a result of the research, it was determined that REBA-CSTP increased the cognitive flexibility levels and communication skills of the experimental group members at a statistically significant level.