Communication Training Program Research Articles

The Moderating Effect of Communication Competence in the Relationship between Emotional Labor and Job Stress in Nurses

Background: This study aimed to investigate the extent to which communication competence, emotional labor and job stress among a group of Korean nurses working in the hospital. Also, the moderating role of nurses' communication competence was evaluated between emotional labor and job stress.Methods: This study used a cross-sectional descriptive design. Data were collected from 309 nurses working in four general hospitals in Korea from June 30 to July 20, 2021. Data were analyzed using descriptive statistics, Analysis of Variance, t-test, Pearson correlation, and Hierarchical Regression with the SPSS/WIN ver. 28.0 program (IBM.Co., Armonk, NY, USA).Results: The average score of emotional labor, job stress, and communication ability was 3.39, 3.51, and 3.47 out of 5, respectively. Emotional labor showed a significant correlation between communication competency and job stress, in the relationship between emotional labor and job stress, the moderating effect of communication competency was found to be significant (<i>β</i>=-0.162, <i>P</i><0.01).Conclusions: The results showed that it is necessary to make efforts to alleviate communication competency, Emotional labor and job stress plays a buffering role in these relationships. It is suggested that an effective communication training program needs to be developed to cultivate communication skills and attitudes that can be applied to nursing practice.

From chaos to creativity: Designing collaborative communication training for the delivery of bad news

BackgroundBefore the COVID-19 pandemic, teaching communication skills in health care focused primarily on developing skills during face-to-face conversation. Even experienced clinicians were unprepared for the transition in communication modalities necessitated due to physical distancing requirements and visitation restrictions during the COVID-19 pandemic. We aimed to develop and pilot a comprehensive video-mediated communication training program and test its feasibility in multiple institutional settings and medical disciplines. MethodsThe education team, consisting of clinician-educators in general surgery and emergency medicine (EM) and faculty specialists in simulation and coaching, created the intervention. Surgery and EM interns in addition to senior medical students applying in these specialties were recruited to participate. Three 90-minute sessions were offered focusing on 3 communication topics that became increasingly complex and challenging: breaking bad news, goals of care discussions, and disclosure of medical error. This was a mixed-methods study using survey and narrative analysis of open comment fields. ResultsLearner recruitment varied by institution but was successful, and most (75%) learners found the experience to be valuable. All of the participants reported feeling able to lead difficult discussions, either independently or with minimal assistance. Only about half (52%) of the participants reported feeling confident to independently disclose medical error subsequent to the session. ConclusionWe found the program to be feasible based on acceptability, demand, the ability to implement, and practicality. Of the 3 communication topics studied, confidence with disclosure of medical error proved to be the most difficult. The optimal length and structure for these programs warrants further investigation.

Foreseen Demands for Up-and-coming Science Communicators and Recommendations for Science Communication Training Programs

Citizens interact with science on a daily basis, yet their understanding and opinions of scientific issues are formed with little scientific information. Science communication literature has called for scientists to take a more active role in engaging with the public through science communication efforts. However, scientists face demands and challenges that dissuade or prevent them from engaging in genuine communication efforts with a lay audience, including a lack of training. There has been an identified need for increased training programs for science communicators and students, but only a small number of programs currently exist. The purpose of this study was to identify demands faced by scientists who participate in communication practice in agricultural disciplines at Texas Tech University and to develop foundations for future science communications training curriculum at the college and/or university level. This descriptive, qualitative study consisted of semi-structured, in-depth interviews with 10 scientists at Texas Tech University who were identified as sought after for a variety of media interviews and communication efforts, and a criterion sampling strategy was used to identify “sought-after” communicators. The results of this study found that major demands faced by scientists include time constraints and academic value, and those demands inhibit genuine science communication efforts. Finally, recommendations regarding pedagogical foundations and subject matter content were developed for implementation in future science communication coursework at Texas Tech University.

Influencing Discharge Efficiency: Addressing Interdisciplinary Communication, Transportation, and COVID-19 as Barriers.

At one tertiary, academic medical center, two general medicine units averaged 94% and 97% occupancy causing strain on patient throughput. This project was implemented at these two comparable general medicine units, totaling 64 beds. On each of these units, Pareto analyses on causal factors related to discharge order to exit time (DOTE) were performed. DOTE was defined as the period in minutes from when a provider orders a discharge to when the patient actually exits a room. Prime DOTE reduction opportunities were elicited that highlighted the need to address coordination of hospital discharge transportation; that is, arriving family members averaged 120 and 129 min for the two units, and medicars and ambulances averaged 122 and 156 min, which fell above the established 90-min overall strategic DOTE goal. Coordinating efficient discharges decreases the likelihood of hospital bottlenecking and improves patient satisfaction. The health care team is composed of physician and provider services, nursing, and case management, as well as the patient and family. Team-focused interventions aimed at reducing DOTE included leveraging interdisciplinary communication technology and messaging for efficiency and accuracy within the health care team and proactive scheduling of hospital discharge transportation arrival. Process objectives measured included percentage of the health care team educated and utilization of the discharge suite. Outcome objectives measured included median DOTE times, patient satisfaction, and emergency department boarding volume and times. Significantly, admissions for coronavirus disease-2019 (COVID-19) cases were also rapidly increasing early on during program implementation resulting in one of the two general medicine units to be designated for COVID-19 overflow. Using Lean methodology, the project design was formed based on the Institute for Healthcare Improvement's work on improving hospital-wide patient flow and the Agency for Healthcare Research and Quality's (AHRQ) IDEAL patient discharge framework to better achieve the well-known, triple aim. In response to COVID-19 demands, the Plan-Do-Study-Act process was warranted to be able to manage acute changes, using iterative processing. This program evaluation study assessed whether a communication training program that taught an interdisciplinary team of case managers, nurses, physicians, and related staff how to reduce DOTE was useful. The program had a material impact on the DOTE metric knowing that the hospital's ultimate strategic goal is to reduce DOTE to 90 min or less. A reduction in discharge time was documented when using weekly data from the hospital's discharge dashboard powered by the Maestro database. More specifically, nurses fully trained in the interdisciplinary communications program aimed to reduce DOTE had significantly lower DOTE outcomes on their discharges compared with untrained staff (i.e., average untrained = 127 min, average trained = 93 min). In addition, the fully trained nurses had 14% more of their discharges fall at or below the 90-min goal compared with untrained staff (i.e., untrained = 40%, trained = 54%). Supplemental research also suggested that the content of the communication training program was very relevant (e.g., empowering families to pick up the patients and using scheduling vs. will-call transportation strategies with patients lowered the DOTE metric). Corollary analyses showed that readmissions were also lowered, and patient satisfaction ratings increased. In addition, the interdisciplinary communications training program can benefit from being updated to include content on how COVID-19 issues adversely impact discharge times since significant relationships between various COVID-19 measures and higher discharge exit times were documented.

The Impact of COVID-19 Pandemic on Homestays and Optimism in Kepulauan Seribu on Tourism Future through Smart Tourism

Tourism stakeholders must seek out innovative tactics to survive and thrive in the face of adversity. Switching to digital media and developing new digital inventions is thought to be the best option (Heliany, 2019; Irwan & Novianti, 2021). Based on this, we consider it important to see the impact of the COVID-19 pandemic on Kepulauan Seribu tourism and its relation to digital communication as an effort to minimize the impact of the pandemic which aims to see the optimism of homestay owners. This article provides an overview of the COVID-19 pandemic impact on tourism business owners of homestays in Kepulauan Seribu until 2021Objectives: This article provides an overview of the COVID-19 pandemic impact on tourism business owners of homestays in Kepulauan Seribu until 2021. This study aims to measure the awareness level of health protocols and the decline in income for homestay owners. This study also aims to describe the future recovery opportunities through the readiness of digital communication towards smart-tourism in Kepulauan Seribu and the optimism of homestay owners in developing their homestays in the future.Methodology: This study uses a quantitative descriptive approach. The collection of questionnaire data uses cluster sampling starting on June 23, 2021 until October 7, 2021 with a total of 308 respondents based on collected questionnaires. The study was carried out on 9 islands during the COVID-19 pandemic and under the policy of Restrictions towards Community Activities (abbreviated to PPKM) by Indonesia’s government. The presentation of descriptive data analysis uses SPSS Version 24. To strengthen the analysis, in-depth interviews were carried out with key informants.Finding: The results of data analysis show a 60% decrease in homestay income and the number of tourists during the COVID-19 pandemic. The biggest use of digital marketing is for imaging activity, followed by digital transaction activity, marketing, and receiving criticism and suggestions as only less than 50% of homestay owners have attended training. Although affected by the COVID-19 pandemic, homestay owners are optimistic to continue to develop the capacity of their homestay in the future.Conclusion: The availability of infrastructure to support smart tourism is sufficient. The readiness of human resources in the form of skills in maximizing the use of digital communication for tourism still needs to be supported through continuous digital communication training programs and assistance by tourism-aware groups. Keywords: COVID-19 pandemic; digital communication; Kepulauan Seribu; smart-tourism

Defining Objective Measures of Physician Stress in Simulated Critical Communication Encounters.

OBJECTIVES:This study had three aims: 1) quantify the difference in stress levels between low and high stress roles during simulated critical communication encounters using objective physiologic data (heart rate variability [HRV]) and subjective measures (State-Trait Anxiety Inventory [STAI]), 2) define the relationship between subjective and objective measures of stress, and 3) define the impact of trainee preparedness and reported self-efficacy on stress levels.DESIGN:Mixed methods simulation-based study.SETTING:Single center.PATIENTS:Pediatric critical care fellows and faculty (n = 12).INTERVENTIONS:Subjects participated in six simulated scenarios in both high stress “hot seat” and low stress “observer” roles.MEASUREMENTS AND MAIN RESULTS:Subjective stress was measured using the STAI at baseline and after each scenario. Objective stress was measured continuously using a wearable biometric device measuring HRV. Previous residency communication training and self-confidence surrounding various communication topics were collected via questionnaire. Significant changes in subjective (STAI) and objective stress (HRV) measurements in the low- versus high-stress roles were observed. STAI scores increased 8 points during low stress and 12 points during high stress role (p = 0.021) compared with baseline. Two specific HRV markers, root mean square of successive differences between normal heartbeats, a marker of parasympathetic tone, and the low frequency/high frequency (LF/HF) ratio, a marker of sympathetic activation, were significantly correlated with STAI levels (–0.032, p = 0.001; 1.030, p = 0.002, respectively). Participants who reported increased confidence in discussing code status had a significant decrease in stress response (measured via LF/HF ratio) during both the observer (p = 0.033) and hot seat roles (p = <0.001).CONCLUSIONS:Communicating life-altering news in a simulated environment is a stressful experience. This stress results in physiologic changes that can be measured continuously using HRV. HRV measurement may serve as a novel method in evaluating the effectiveness of communication training programs and measuring future stress-reduction interventions.

Lesson Learned From Hospital Palliative Care Service in a Cancer Research Center in Italy: Results of 5 Years of Experience.

BackgroundInternational studies have documented that over a third of all hospital beds are occupied by patients with palliative care needs in their last year of life. Experiences of Palliative Care Services that take place prevalently or exclusively in hospital settings are very few in Italy.ObjectiveDescribe clinical, educational and research activities performed by a hospital PCS and discussing opportunities and critical issues encountered in an Italian Cancer Center.MethodRetrospective data regarding adults with advanced stage diseases referred from January 2015 to December 2019.Results Clinical activity - The PCS performed 2422 initial consultations with an average of 484 initial consultations per year. A majority of patients had advanced cancer, from 85% to 72%, with an average of 2583 total consultations per year and an average of 4.63 consultations per patient. The penetrance has increased over time from 6.3% to 15.75%. Educational and research activity - Since 2015, PCS has provided training to health professionals (HPs) of different departments of our hospital. Most of the educational projects for HPs were part of research projects, for example the communication training program, management of pain and end-of-life symptoms and the training program for PC-based skills.ConclusionOur data suggests that a PCS able to provide palliative care to inpatients and outpatient and continuous training support to other hospital specialists can relatively quickly improve the level of its penetrance in hospital activities.

중소병원 간호사의 안전 동기, 상사 신뢰, 조직 의사소통 만족, 환자 안전 침묵이 근접 오류보고 의향에 미치는 영향

This study conducted to provide basic data on developing management and intervention strategies for improving near miss reporting in small and medium-sized hospitals by identifying the degree of willingness of nurses to report near miss and factors influencing their willingness to report such occurrences.&#x0D; The participants were 205 nurses. who were recruited from the 4 small and medium-sized hospitals with more than 200 beds in K-city, Gyeongnam Province. The structured questionnaire was self-administered from June 20 to July 20, 2019. Data were analyzed through the SPSS/WIN 24.0 program using descriptive statistics, Independent t-test, one-way ANOVA, Scheffé test, Pearson’s correlation coefficient, and stepwise multiple regression.&#x0D; According to the results of this study, The degree of participants’ willingness to report near miss was 73.41 out of 100 points. The degree of patient safety silence was 2.27 out of 5 points . The degree of the safety motivation was 3.22 out of 5 points . The degree of faith in supervisor was 4.01 out of 5 points . The degree of satisfaction with the organization's communication was 3.31 out of 5 points . The factor of patient safety motivation(β=.328, p&lt;.001), patient safety silence(β=-.285, p&lt;.001), and safety accident reporting procedure(β=.142, p=.021) were impact on the willingness to report the near-miss level of nurses. The total explanatory power accounted for 26.2%.&#x0D; In conclusion, factors that affect the willingness of nurses to report near misses in small and medium-sized hospitals were safety motivation, patient safety silence, and safety accident reporting procedures. Therefore, in order to increase the willingness of nurses to report near miss in small and medium-sized hospitals, safety incentives should be enhanced through patient safety education, and communication training programs for individuals. Moreover, organizations should be applied to reduce patient safety silence. Additionally, the reporting procedure should be clarified and simplified so that nurses in small and medium-sized hospitals understand w the safety accident reporting procedure well and can access it easily.

Pelatihan Komunikasi Asertif untuk Meningkatkan Pengetahuan Pencegahan Napza pada Siswa Sekolah Menengah Pertama YWKA II Jakarta Timur

ASSERTIVE COMMUNICATION TRAINING TO IMPROVE DRUGS PREVENTION KNOWLEDGE IN FIRST HIGH SCHOOL STUDENTS YWKA II EAST JAKARTA. The high number of drug abuse among students in DKI Jakarta is a big task for Guidance and Counseling Teachers to carry out preventive and curative efforts. The solution offered is to organize an assertive communication training program to increase drug prevention knowledge in students. This research is an experimental study to see the effectiveness of this program carried out at YWKA II East Jakarta junior high school. This study found that the implementation of an assertive communication training program was proven to increase students' knowledge of drug prevention. Based on these results, it is recommended for the government and school leaders to conduct an assertive communication training program to prevent drug abuse in students as a preventive effort that needs to be done early on, especially for junior high school students entering their early teens.

Application of the Six-Step Standard Communication Process in the Communication Training for Newly Recruited Nurses in Cancer Specialist Hospitals.

PurposeDiscuss the application effect of the six-step standard communication process in the communication ability training of newly recruited nurses.MethodsThis is a before and after control study. The control group included 45 newly recruited nurses in our hospital in 2019, and the observation group included 40 newly recruited nurses in our hospital in 2020. The control group completed the training according to the existing communication training program, and the observation group implemented a training program based on the “six-step standard communication process” on the basis of the existing communication training. The training period was 12 months. The training effect of the two groups of new nurses was compared.ResultsAfter training, the total scores of clinical communication skills of the new nurses in the control group and observation group were 252.56 ± 24.950 and 268.05 ± 19.335 points, respectively; the total scores of communication behavior were 39.00 ± 4.676 and 48.08 ± 2.515 points, respectively; the total scores of general self-efficacy were 26.89 ± 3.017 and 31.25 ± 5.027 points, respectively; the satisfaction scores of communication training were 17.56 ± 2.018 and 19.45 ± 0.986 points, respectively, and the differences were statistically significant (P < 0.05).ConclusionThe implementation of a training program based on the “six-step standard communication process” can effectively improve the clinical communication skills and self-efficacy of newly recruited nurses, and can be promoted and applied to the communication training of newly recruited nurses.

What Did They Learn? Objective Assessment Tools Show Mixed Effects of Training on Science Communication Behaviors

There is widespread agreement about the need to assess the success of programs training scientists to communicate more effectively with non-professional audiences. However, there is little agreement about how that should be done. What do we mean when we talk about “effective communication”? What should we measure? How should we measure it? Evaluation of communication training programs often incorporates the views of students or trainers themselves, although this is widely understood to bias the assessment. We recently completed a 3-year experiment to use audiences of non-scientists to evaluate the effect of training on STEM (Science, Technology, Engineering and Math) graduate students’ communication ability. Overall, audiences rated STEM grad students’ communication performance no better after training than before, as we reported in Rubega et al. 2018. However, audience ratings do not reveal whether training changed specific trainee communication behaviors (e.g., jargon use, narrative techniques) even if too little to affect trainees’ overall success. Here we measure trainee communication behavior directly, using multiple textual analysis tools and analysis of trainees’ body language during videotaped talks. We found that student use of jargon declined after training but that use of narrative techniques did not increase. Flesch Reading Ease and Flesch-Kincaid Grade Level scores, used as indicators of complexity of sentences and word choice, were no different after instruction. Trainees’ movement of hands and hesitancy during talks was correlated negatively with audience ratings of credibility and clarity; smiling, on the other hand, was correlated with improvement in credibility, clarity and engagement scores given by audience members. We show that objective tools can be used to measure the success of communication training programs, that non-verbal cues are associated with audience judgments, and that an intensive communication course does change some, if not all, communication behaviors.

Training Physicians in Motivational Communication to Address Influenza Vaccine Hesitation: A Proof-of-Concept Study.

Background: Strategies to support health care professionals on how to address vaccine hesitancy are needed. Methods: We developed a 4-h Motivational Communication (MC) training program tailored to help physicians address hesitancy related to influenza vaccination among patients living with rheumatoid arthritis. Five MC competencies were evaluated at baseline and post-training with a standardized patient using the Motivational Interviewing Treatment Integrity [MITI] scale. Adherence to MC during clinical consultations and changes in vaccine intentions was measured as secondary outcomes. Results: Seven rheumatology physicians participated in the training. MITI scores increased in all participants, and 71% (n = 5) achieved thresholds of clinical competency (i.e., ≥3.5/5 at MITI global score and ≥3/5 on at least 3 individual competency score) post-training. Autonomy/support and empathy competencies reached competency thresholds (+2.4 ± 1.3 to +4.1 ± 0.7 and +2.1 ± 0.7 to +4.1 ± 0.7, respectively). Evocation and collaboration competencies improved but without reaching competency thresholds (+1.4 ± 0.8 to +3.1 ± 1.1; +1.4 ± 0.8 to +2.9 ± 1.1, respectively). Direction did not improve. Among 21 patient consultations post-training, 15 (71%) were MC-consistent. Of the 15 patients, 67% (10/15) intended to receive the influenza vaccine and 33% (5/15) received it. Conclusion: A brief MC training program targeting vaccine hesitancy increased MC competency among rheumatology physicians and promoted behavioral change among patients.

Improved Patient Experience and Outcomes: Is Patient-Provider Concordance the Key?

Health disparities remain ubiquitous in the United States despite initiatives by the federal government and other organizations. A long-term solution for health inequity is needed in order to help improve patient outcomes for all. The purpose of this review is to examine if racial, gender, or multifactorial concordance (eg, race, age, gender, education, language) between patient and provider leads to a better patient experience and improved health outcomes. A PubMed search for articles published between 2016 and 2021 resulted in 23 separate studies that met inclusion criteria. The results from these studies were inconclusive in determining an association between patient–provider concordance and patient outcomes. Further research is needed to evaluate the positive, neutral, and sometimes negative impact of patient–provider concordance. By diversifying healthcare professions and improving cultural competency and communication training programs, providers may be better prepared to care for diverse populations in both concordant and discordant patient relationships.

Introducing Communication Skills Training among Interns using Attitude, Ethics, and Communication Module.

Communication skills are the backbone for patient care services such as patient interviews, counseling the patient, and explaining treatment options. The present study was conceived to evaluate the communication training program and perceptions of medical interns and faculty regarding the same. Sixty medical interns were included in this cross-sectional study. Training on communication skills was imparted which was later assessed on the basis of Kalamazoo scale. Attitude of the interns regarding communication skill training was assessed using Rees and Sheard Scale. The attitude of faculty regarding introduction of communication skill was also assessed. The mean score on Kalamazoo Consensus Scale was 19.65 ± 4.97 with a range of 10-29. Females had a higher score (21.09 ± 5.80) as compared to males (17.88 ± 3.21), but this was not statistically significant (P = 0.157). The mean score for positive and negative attitude scale was 59.15 ± 5.51 and 25.20 ± 9.60. The ability to communicate effectively is a core competency expected of medical graduates and communication skills training of medical students and interns with the help of didactic lectures, role plays, and videos, etc., can go a long way in improving their communication skills.

Implementing SAFER Responses to Misconduct and Responding to Biased Patient Requests ASAP.

Background: In response to encounters involving misconduct, discrimination, and harassment toward healthcare workers, the Experience Training, Education, and Coaching (XTEC) team was tasked with empowering staff members to respond to biased requests and misconduct appropriately and consistently. The aim of this article is to discuss communication strategies for how to respond to patient bias and misconduct. Methods: XTEC developed a training program with two focused communication strategies: (1) SAFER, a stepped approach to respond to patient and visitor misconduct and (2) ASAP, an approach for responding to patient bias which we describe as requests related to race, religion, ethnicity, gender, and other personal attributes of staff. Intervention: SAFER ASAP workshops were delivered to 2154 health care professionals through 109 face-to-face training over a 15-month period between January 2019 and March 2020. All trainings were discussion- and scenario-based, ranging in duration from 60 to 90 min. Participants were given pre- and post-training test case scenarios, in which respondents wrote responses to a challenging behavior to assess skill attainment post-training. Results:Seventy-one percent demonstrated higher levels of response ability post-training, and 92% of respondents indicated they would likely recommend this training to others. Conclusions: SAFER ASAP is an effective communication training program for responding to patient and visitor bias and misconduct.

Communication training programmes for informal caregivers of people living with dementia: A systematic review.

Current research suggests that communication training programmes for caregivers of people living with dementia can benefit both parties by improving communication, quality of life and stress. Previous reviews in this area focus on mixed samples of formal and informal caregivers. This review aimed to evaluate current research for trainings specifically for informal caregivers, including the research quality and the key training components. The review followed the PRISMA research reporting checklist. The electronic databases CINAHL, Embase, Medline and Psychinfo and reference lists of included literature were searched for studies relevant to the aims. Of the 45 identified studies, 36 were excluded based on pre-specified criteria. Nine studies were included in the final review and subject to quality appraisal using the Qualsyst tool. The included studies' programmes averaged 5 to 6hours in length over four to five sessions, were mostly face to face in both group and individual settings and were developed using various communication and psychological theories. Studies demonstrated variable quality and outcomes, making it difficult to identify optimal components. However, careful consideration of different factors enabled some suggestions for training dose, delivery method, content and outcomes to measure. Communication training programmes can benefit people living with dementia and their informal caregivers in outcomes such as communication skills and quality of life. Suggestions are made on the training components that optimise these benefits. Given the clear benefits on outcomes such as quality of life, there is a need for communication trainings to be offered in clinical contexts. However, given the limited pool of variable quality research and lack of accessible manuals, it is unlikely that this is the case. Consolidating and widening the evidence through further research is essential in making these trainings more widely available.

Study protocol: Clinical yarning, a communication training program for clinicians supporting aboriginal and Torres Strait Islander patients with persistent pain: A multicentre intervention feasibility study using mixed methods

ObjectivesIneffective communication between healthcare clinicians and Aboriginal and Torres Strait Islander patients with persistent pain is a significant barrier to optimal pain management. This manuscript is a study protocol and describes the development and evaluation methods of a tailored, culturally-informed training program, to improve clinicians’ communication with patients. Study designThis is a single-arm, multicentre (2 metropolitan and 1 regional persistent pain service) intervention feasibility study that will be evaluated using mixed methods. MethodsA communication training program will be developed informed by qualitative interviews with key stakeholders, and adapt the patient-centred ‘clinical yarning’ framework for the Queensland context. Evaluation of the effectiveness of the training will involve the analysis of quantitative data collected at three study sites over a 12-month period. At the patient level, communication experience will be rated at differing times of the training rollout to reflect participants' experience of communication either prior to or following the treating clinician attending the communication training. At the clinician level, evaluation of the training program will be based on changes of ratings in the importance of training, knowledge, ability and confidence to communicate with Aboriginal and Torres Strait Islander patients; satisfaction, acceptance and relevance to their clinical practice. This study will be grounded in the needs and preferences of communication of Aboriginal and Torres Strait Islander people living with pain. ConclusionIt is hypothesized that the patient-centred intervention will have immediate benefits for patients, improving patient experience of care. This research will focus on an area of unmet need in addressing persistent pain.

Development of educational system for paramedics specializing to dementia elderlies analyzed by artificial intelligence and its learning effects

AbstractBackgroundWhile the number of emergency transfer of dementia elderlies to acute care hospitals has being increasing, paramedics are facing challenges to perform their duties promptly due to difficult communication with patients.ObjectivesTo develop the standardized educational system for paramedics specializing to dementia elderlies with the use of artificial intelligence.DesignSingle arm, pre‐post study. Participants are paramedics in a metropolitan area of Japan.ExposureThe two sessions of standardized multimodal communication training program which contains lecture and workshop were provided twice, 1 month apart. The training consists three parts. 1: Mechanism and clinical manifestations of dementia, 2: Communication skills: face‐to‐face interaction; mutual gaze, geometric characteristics and duration of eye contact, verbal communication with phonetic elements, and touch interactions. 3: Interaction strategies with dementia elderlies in emergency situation. All participants performed the rescue simulation training before the training and 1 month after the completion of the training, which were video‐recorded and analyzed by artificial intelligence (AI). The video was taken by wearable camera with eye‐trackers (1st person camera) and fixed camera (3rd person camera). The satisfaction survey of effectiveness on their work and the Jefferson Scale of Empathy for healthcare professionals were also taken.Main OutcomesThe primary outcome is the change of communication skills in physical position, distance, eye contact with patients, phonetic elements and touch. The system to analyze face‐to‐face communication; mutual gaze, geometric characteristics and duration of eye contact by AI was developed by our team. Other elements of communications were evaluated manually. Secondary outcome were satisfaction and the empathy to patients.Result31 paramedics enrolled the study. Prior to the training, 88% had experienced any difficult condition taking care of dementia patients. The video analysis showed significant change of the interactive communication in the direction of approach, eye contacts and duration of mutual gaze. 96.7% considered the training was effective for their daily work and 97.5% of participants recommended this training to a colleague. The score of empathy scale showed no significant change.ConclusionThe educational system for paramedics specializing to dementia with the use of artificial intelligence is effective for their work.

The effect of a relationship-centered communication program on patient experience and provider wellness

ObjectivesDespite evidence of the central importance of communication to patient experience, health outcomes, and provider wellness, communication training for clinicians is not a standard part of clinical education. The study explores the impact of an 8-hour relationship-centered communication (RCC) training program on patient experience and provider wellness. Methods636 healthcare providers participated in 48 workshops conducted January-August 2018. 481 (76%) agreed to participate in research. Participants completed a pre/post assessment that included a wellness survey, the Professional Fulfillment Index (PFI). We conducted chi-squared analyses comparing wellness data immediately prior to the course to 3 months following course participation. Patient experience, assessed using Press Ganey likelihood to recommend care provider (PG-LTR CP) scores, were examined prior to an individual’s course participation and following participation up to September 2019. Results104 participants completed the three-month PFI (22% response rate). Participants demonstrated marked improvements in professional wellness after 3 months. In bivariate analyses, PG-LTR CP significantly increased and persisted more than 7 months following program completion. ConclusionsThe RCC training program, a low-cost communication intervention, led to significant, beneficial changes in provider wellness and patient experience. Practice implicationsImplementing a RCC course for providers may improve patient experience and provider wellness.

Effectiveness of Adlerian-based Educational Program on Decision Making Problems of Spouse Selection and Attitude Toward Marriage and Divorce among Children of Divorced Parents

Background and Aim: One of the most important complications of parental divorce for children is uncertainty about marriage and its outcomes and, in the next step, doubts about decision making about choosing a suitable spouse. This study aimed to determine the effectiveness of Adlerian educational program on the problems of choosing a spouse, attitude toward marriage and divorce of children of divorced parents. Materials & Methods: This study was a quasi-experimental study with pre-test, post-test, and follow-up design with a control group. This study's statistical population was all divorced children referred to a counseling center in Tehran, 60 of whom were selected by convenience sampling method and randomly divided into two groups of 30 experimental and control. Premarital education was conducted based on the communication training program for the experimental group. Before the intervention and the final session, pre-test and post-test were taken, and follow-up was performed 45 days after the post-test. Data were collected using the decision problems in spouse selection questionnaire (2004), marriage attitude scale (1998) and attitude toward divorce (1986) were analyzed using one-way covariance analysis and SPSS.22 software. Results: The results showed that the Adlerian educational program was effective on choosing a spouse (p <0.01), attitude toward marriage (p <0.01), and attitude toward divorce (p <0.01) of children of divorced parents.Conclusion: It can be concluded that Adlerian's educational program was effective on increasing attitude toward marriage and decreasing decision problems and attitude toward divorce of children of divorced parents.