Need For Communication Training Research Articles

Medical improvisation helps speech therapists to improve their communication skills.

Speech therapists are supposed to be experts in communication, but communication teaching remains uncommon in their curricula. Despite the well-documented benefits of effective and empathetic communication, there is a lack of available resources, and communication training remains challenging. While medical improvisation training grows in health student curricula to develop communication skills, it has not been extended to speech therapy. Medical improvisation is a practice based on non-scripted theatre, using theatrical improvisation tools to train health professionals and help them develop specific skills.1 It allows a safe space and experiential learning to develop effective and empathetic communication (i.e. to listen actively, express clear messages and appropriate emotions) through exercises involving all communication dimensions (verbal, para and non-verbal). Students can fail and try multiple times within this safe space. We explored speech therapists' experience with and interest in medical improvisation training for communication skills. Since 2018, speech therapist students (fourth year) at out institution had a non-mandatory medical improvisation training within their curriculum, and 21 of them attended ten 2-hour sessions weekly with a professional improv facilitator. The first course focused on improv general rules (listen actively, accept proposition: say ‘yes, and…’ instead of ‘yes, but…’). The following courses improved the basic skills (speak in public) with various exercises focusing on the following: voice, posture, proxemics and leading to embody other person's perspective and emotions (empathy). Then, these skills were used to train speech therapist students within inspired-by-real-life-experience clinical situations. For example, the speech therapist students enacted ‘the worst way to’ deal with a patient or a rude colleague. Debriefing allowed faculty to illustrate behaviours to avoid in clinical situations and how to improve them. Then, students had to play the same scenario using ‘the best way to…’ to improve their self-personal efficiency. Unlike classical role play, medical improvisation training encouraged learners to fail and then try to improve. We explored speech therapist students' experience and interest through post-improv questionnaires and their verbal feedback. This effort supports the need for communication training (‘I need to be more comfortable for speaking (....) control my voice’) with feedback about medical improvisation training being broadly positive (‘I retained exercises that could be useful in my future professional practice’). Most students (67%) re-used the improv exercises and strategies (breathing) in a professional context: during their oral examinations and internships (e.g. to explore child's imagination, make the exercises enjoyable). The first students who attended these classes, now clinicians, started to use improv techniques with patients as part of therapy (e.g. work on prosody and facial expression with a parkinsonian syndrome patient), with positive anecdotal feedback (relaxation, pleasure and subtle gestures improvement). Medical improvisation appears valuable to speech therapist students and could, thus, lead to development of new rehabilitation strategies in the future. Beyond communication skills, it also could be beneficial to deal with uncertainty. JDW designed the work, analysed and interpreted the data and drafted the word. MH designed the work, analysed the data, revised the work and gave its final approval and agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of the work are appropriate. MG contributed to the concept the work, revised the work and gave its final approval and agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of the work are appropriate.

Violence against healthcare workers br Hungarian experiences

Introduction: Violence against healthcare workers damages not only the health and dignity of employees but also the safety and productivity of institutions. Violence in healthcare also poses a threat to patient safety and the quality of patient care. Objective: The aim of the research is to get an idea of whether healthcare workers in Hungarian healthcare institu-tions, if they get involved in violent conflict, have someone to turn to at their workplace. It aims to explore whether communication, simulation and self-defense trainings are held in institutions, and to examine the relationship be-tween these prevention and treatment trainings with confidence. Method: Cross-sectional quantitative research has been conducted with an online questionnaire involving 720 health professionals. Results: It can be stated that when an atrocity hits a healthcare worker, he or she turns to his or her colleague during the violence and, after atrocity, asks the head nurse or a psychologist for help in processing the problem. 52% of verbal violence and 45% of physical violence were not reported by employees. A very high percentage (39%) of work-ers do not even know who to turn to if they are subjected to violent atrocity. The data show that communication training alone is not enough to make healthcare workers confident. However, participation in this training does not significantly reduce the average number of atrocities experienced in a year. Conclusion: The results obtained may also signal the need for communication training, but it is not enough in itself, it should be followed by simulation practice as well as self-defense education and practice. Participating in other communication or violence prevention training increases the confidence of healthcare workers, but communication training alone does not. There is no reporting obligation in the institutions so a lot of atrocities remain hidden.

Medical errors: Experiences, attitudes and perspectives ofincoming and outgoing final-year veterinary students in the USA.

Medical errors have an impact on veterinary patient safety. Studies in human medicine suggest that students can help prevent medical errors. However, there are no studies that address the role of veterinary students in patient safety. An electronic survey was distributed to incoming final-year (IFY) and outgoing final-year (OFY) students at the Washington State University College of Veterinary Medicine. Response data were compared between class year groups with a Fisher's exact test and Mann-Whitney U test. The response rate was 26.8% (70/261). Most respondents (85.7%) reported being present during a medical error, and 60% reported causing a medical error. The OFY group indicated lower agreement with documenting an error in the patient record and whether all errors should be disclosed. The IFY group felt more distress surrounding potential errors and sequential career implications. Compared with the IFY group, the OFY group agreed more that errors occur frequently in veterinary medicine and disagreed more that hospital staffing is adequate to ensure patient safety. Open responses recognised a need for communication training and identified that the OFY group regarded errors more actionably, whereas the IFY group viewed errors more emotionally. Most veterinary students will experience medical errors prior to graduation, but some lack clarity around appropriate disclosure and documentation. Additional training on medical errors and error disclosure should be provided to veterinary students.

Advancing interprofessional education in communication.

The objective of this training project is to develop and host Interprofessional Communication courses to improve interdisciplinary communication in oncology care. The initial national course was held in a virtual format and included pre- and post-course participant data. The curriculum was developed with support from the National Cancer Institute. A virtual two-day course was held to equip nurses, social workers, and chaplains with vital communication skills in oncology practice, so that they could return to their home institutions and teach communication skills to other healthcare professionals, with the intention of making improved communication a quality improvement goal. Fifty-two participants were selected through an application process to attend the virtual course in two-person interprofessional teams (e.g., nurse and chaplain, or social worker and nurse). The Interprofessional Communication Curriculum was based on the National Consensus Project for Quality Palliative Care's eight domains of quality palliative care. The six online modules developed by the investigators were presented in lectures, supplemented by discussion groups, role plays, and other methods of experiential learning. Pre- and post-course results identified areas of communication, which are a priority for improvement by oncology clinicians. Participant goals identified specific strategies to be implemented by participants in their settings. The need for communication training was clearly demonstrated across professions in this national training course. Participants were able to apply course content to their goals for quality improvement in cancer settings.

Medical education leadership: from diversity to inclusivity.

Both in Canada and globally, medical schools are prioritizing diversity in medical education. The ensuing development of innovative approaches to augmenting the representation, comfort, and success of students from under-represented groups has been increasing. Curricula have also expanded to better prepare graduates for the realities of effectively meeting the needs of a diverse patient population. Leadership has however, not kept up with this progress. Evidence shows that diverse leadership teams develop innovative solutions to complex problems, recruit and retain the best talent, and remain relevant to the communities they serve. Our international conference workshop included a literature review on the current state of diversity in medical education and in leadership for medical educators, and case-based models of lived experiences to initiate conversations in three different facets of diversity to stimulate reflection, engagement and discussion. The oft-forgotten side of the conversation in conference offerings, the audience’s perspective, was purposefully included in planning the workshop and presenters adhered to this principle throughout the session. Participants recognized the importance of addressing diversity with leadership in medical education. Themes included the need for communication training, cultural education, sharing these data more broadly with faculty in medical education and continuing these conversations. A final theme “we will never represent all minorities”, led us to a conclusion that a culture of inclusivity and not diversity would be required to successfully meet this challenge.

Cultural competency in dietetic diabetes care-A qualitative study of the dietician's perspective.

IntroductionDiabetes type 2 is more prevalent in ethnic minorities in the Netherlands, and outcomes of health care in general are worse compared to other Dutch patients. The purpose of this study is to explore the experiences of dieticians and the knowledge, skills and attitudes they consider to be important for effective dietetic care in migrant patients.MethodsSemi‐structured interviews were held with 12 dieticians, of various ages, ethnic backgrounds and experience. The interview guide was based on Seeleman's cultural competence model and the Dutch dietetic consultation model. Interviews were transcribed, coded and thematically analysed, revealing 7 main themes.ResultsDieticians were uncertain whether their care fulfilled their migrant patients’ needs. They experienced language differences as a major barrier for retrieving information and tailoring advice to the patient's needs. Furthermore, dieticians feel they lack cultural knowledge. An open and respectful attitude was considered important for effective care. The communication barrier hindered building a trusting relationship; however, few dieticians mentioned a need for communication training. They expressed a need for cultural competence training, specifically to acquire cultural knowledge.ConclusionDieticians struggle with providing dietetic care for migrant diabetes patients due to communication barriers and difficulty in building a trusting relationship. They are conscious of their lack of cultural knowledge, and acknowledge the need for an open and respectful attitude and essential communication skills in order to collect and convey information. They seem unaware of the impact of low (health) literacy. Cultural competence training is needed for effective dietetic care for migrants.

Physician-patient communication: A qualitative study of perceptions, barriers, and needs in 4 EU MS

Abstract Background Good physician-patient communication is an important aspect of patient-centered care and contributes to positive health outcomes. However there is a lack of standard EU communication training policies for physicians. This study explores the barriers to good communication for both physicians and patients across four EU countries as part of the EU-funded Project “H-COM”, Health Communication Training for Health Professionals. Methods Eight focus groups were conducted with a total of 31 patients and 38 physicians from Germany, Greece, Spain, and Cyprus. Three themes were covered; perceptions, barriers and needs for health communication. Results Commonalities and differences between countries and target groups were identified, with participants discussing attitudinal, emotional, educational, and systemic barriers to good communication. Identified barriers among patients include a deeply embedded hierarchical notion and arrogance among physicians, inadequate or difficult to understand language, busy schedules. Among doctors barriers identified were mostly systemic having to do with busy schedules, large number of patients, and lack of time. Participants especially patients indicated a significant gap in health communication knowledge, skills, and training for physicians, with several regional differences being present especially between Mediterranean and central European countries. Conclusions The results imply a strong need for communication training, tailored accordingly in specific countries. Further development of policies related to the inclusion of such training in medical studies across EU would be of great importance. Key messages There are differences concerning health communication needs and barriers between EU regions and the development of tailored training. Although identified as important there is a lack of health communication training in certain EU MS and an urgent need to incorporate training in basic medical and nursing education.

Initiating discussions about weight in a non-weight-specific setting: What can we learn about the interactional consequences of different communication practices from an examination of clinical consultations?

ObjectivesEffective clinical communication is fundamental to tackling overweight and obesity. However, little is known about how weight is discussed in non‐weight‐specific settings where the primary purpose of the interaction concerns clinical matters apparently unrelated to weight. This study explores how mental health clinicians initiate discussions about a patient's possible weight problem in the non‐weight‐specific setting of a UK NHS Gender Identity Clinic (GIC), where weight is topicalized during discussions about the risks of treatment.DesignA conversation analytic study.MethodsA total of 194 recordings of routine clinician–patient consultations were collected from the GIC. Weight talk was initiated by four clinicians in 43 consultations. Twenty‐one instances contained reference to a possible weight problem. Transcripts were analysed using conversation analysis.ResultsClinicians used three communication practices to initiate discussion of a possible weight problem with patients: (1) announcing that patients are overweight; (2) asking patients whether they are overweight; and (3) deducing that patients are overweight or obese via a body mass index (BMI) calculation. Announcing that patients are overweight is the least aligning practice that denies patient's agency and grammatically constrains them to agree with a negative label. Asking patients whether they are overweight treats them as having limited agency and generates comparatively aligning, but occasionally resistant, responses. Jointly deducing that patients are overweight or obese via a BMI calculation is the most aligning practice, which deflects responsibility for labelling the patient onto an objective instrument.ConclusionsSmall differences in the wording of turns that initiate discussions about a possible weight problem can have significant consequences for interactional alignment. Clinicians from different specialities may benefit from considering the interactional consequences of different practices for initiating discussions about weight during the kinds of real‐life discussions considered here. Statement of contribution What is already known on this subject? There is a correlation between clinical communication about weight and patient weight loss.Clinicians from all specialties are encouraged to discuss diet and exercise with patients, but communication about weight remains problematic.Health psychologists have identified an urgent need for communication training to raise sensitive topics like weight without damaging the doctor–patient relationship. What does this study add? Clinicians in a non‐weight‐specific setting use three communication practices to introduce the possibility that a patient's weight may be a problem.These practices have varying consequences for the interaction and doctor–patient relationship.Conversation analytic findings may be useful in training clinicians how to initiate discussions about weight with patients.

Improving Dairy Organizational Communication from the Veterinarian's Perspective: Results of a Continuing Veterinary Medical Education Pilot Program

The increasing size and complexity of US dairy farms could make it more difficult for a veterinary practitioner to effectively communicate protocol recommendations for prevention or treatment on the farm. A continuing education workshop was set up based on the results of research on dairy organizational communication on dairy farms, which resulted in a tool to assess dairy communication structure and flow. The workshop specifically focused on communication structure and whom to talk to when implementing health care changes in calf rearing. In addition, modern methods of veterinary-client communication knowledge and skills were provided. Primary outcomes of the workshops were to obtain feedback from participants about research findings and the communication model, to improve awareness about the complexity of communication structures on dairy farms, and to change participants' knowledge and skills associated with on-farm communication by providing communication theory and skills and an approach to evaluate and improve dairy organizational communication. Of the 37 participants completing the pre-program assessment, most recognized a need for themselves or their practice to improve communication with clients and farm employees. After the program, most participants were confident in their new communication skills and would consider using them. They highlighted specific new ideas they could apply in practice, such as conducting a "communication audit." The results from the assessment of this communication workshop, focused on dairy veterinarians, highlighted the need for communication training in this sector of the profession and practitioners' desire to engage in this type of training.

You Do What ? You Work Where ?

You Do <i>What</i> ? You Work <i>Where</i> ?

Do implantable cardioverter defibrillators complicate end-of-life care for those with heart failure?

We know deactivating implantable cardioverter defibrillators (ICDs) is permissible and should not complicate end-of-life care. However, patients and healthcare professionals still struggle with this concept. This review looks at the recent literature to find possible reasons behind this. ICD use is on the increase and is not always in accordance with best practice guidelines. The number of clinicians having conversations about deactivation is variable, but most of them agree that it is ethical and legal. Difficulty in initiating conversations is mainly due to lack of training, viewing ICDs as being different to conventional treatments and lack of clarity about legality. Patients' knowledge around deactivation and its ethical and legal standing is low. This can be improved by giving information about end-of-life options at the time of implantation and incorporating these within care plans. Use of ICDs should be reviewed in context of disease status and patients' goals. Deactivation of ICDs at end of life throws up challenges for clinicians and patients. This review points toward a need for communication training for clinicians and early initiation of discussion around the time of ICD insertion, as well improving clinicians' and patients' knowledge of the ethics and legality of deactivation.

The Role of Self-Reflection in Palliative Care Education: A Pilot Study of Students Attitudes and Perspectives on End-of-Life Care (740)

1.Discuss the need to assess students’ experiences and attitudes when incorporating a new palliative medicine curriculum into medical schools.2.Recognize the role of self-reflection as a key component to evaluating students’ competency in end-of-life care. Background. An innovative, longitudinal educational program in end-of-life (EOL) care is being integrated across all four years of medical school at University of Chicago (UC). Self-reflection is one modality of evaluation proposed in the literature to assess students’ comfort in dealing with death and dying. The validity and utility of this method of evaluation is being explored at UC. Research objectives. (1) Assess medical students’ experiences and attitudes towards EOL care utilizing a death attitudes survey and narrative exercises. (2) Perform a qualitative analysis of narratives to assess their utility as an evaluation method. Methods. First-year medical students enrolled in a 4-week elective comprised of didactic and experiential training. Data includes pre/post course (N = 11) attitudes surveys (2008 and 2009) utilizing an adapted version of Bugen's Coping with Death Scale and self-reflection exercises (five per student, N = 4, 20 essays total, 2009) detailing (1) personally experienced loss; (2) attitudes/expectations of one's own death; (3) experience with communication of bad news; (4) meaning of suffering; and (5) EOL decision making and surrogacy. Results. Analysis of attitudes surveys using a paired samples test showed a significant increase in mean scores from 109 to 146 (p < 0.001, SD = 24). Themes emerging from the qualitative narrative analysis included students’ attitudes towards (1) different coping methods for personal loss; (2) preferences for place of death; (3) perceived need for communication training; (4) heterogeneous interpretation of suffering; and (5) early advance care planning. Implications for research, policy, or practice. Future research will explore the longitudinal use of narrative exercises as an evaluation tool during implementation of the new EOL curriculum at UC.

Assessing the need for communication training for specialists in poison information

Introduction. Effective communication has been shown to be essential to physician–patient communication and may be even more critical for poison control center (PCC) calls because of the absence of visual cues, the need for quick and accurate information exchange, and possible suboptimal conditions such as call surges. Professionals who answer poison control calls typically receive extensive training in toxicology but very little formal training in communication. Methods. An instrument was developed to assess the perceived need for communication training for specialists in poison information (SPIs) with input from focus groups and a panel of experts. Requests to respond to an online questionnaire were made to PCCs throughout the United States and Canada. Results. The 537 respondents were 70% SPIs or poison information providers (PIPs), primarily educated in nursing or pharmacy, working across the United States and Canada, and employed by their current centers an average of 10 years. SPIs rated communication skills as extremely important to securing positive outcomes for PCC calls even though they reported that their own training was not strongly focused on communication and existing training in communication was perceived as only moderately useful. Ratings of the usefulness of 21 specific training units were consistently high, especially for new SPIs but also for experienced SPIs. Directors rated the usefulness of training for experienced SPIs higher for 5 of the 21 challenges compared to the ratings of SPIs. Discussion. Findings support the need for communication training for SPIs and provide an empirical basis for setting priorities in developing training units.

The communication training needs of registered nurses.

The purpose of this study was to determine registered nurses' (RN) perceived levels of communication effectiveness and need for communication training. Results of the survey indicate that RNs view themselves as fairly effective in using most job-related communication skills except for performance appraisal interviewing, public speaking, and persuasion. The majority of RNs had received training in most communication skills, the exceptions being persuasion and employment interviewing. The two most prominent sources for this training were college and on-the-job training. The results also indicate that RNs believe a variety of communication skills, including presentational speaking, listening, persuasive speaking, group problem solving, leadership, and technical report writing, are important to their job performance. The majority of RNs thought they needed additional training in these skills and were willing to receive such training. Their preferences for receiving the instruction were in-house or industry-based training seminars and profession-sponsored continuing education programs.

Professional Training as a Tool of Skill Building and Morale Enhancement

At no time is professional training more important for employees than during difficult economic periods. With smaller budgets and a reduced workforce, management can introduce professional training programmes as a means of increasing staff morale while concurrently communicating a message that management does care. Profiles a major hotel/casino in Las Vegas, Nevade (USA) in a detailed case study; a survey indicates that managers perceive a significant need for communication training.

Conceptual, Traditional And New Media Training Needs: A Study of County Extension Agent Perceptions

This study examines the extent to which county Extension agents perceive their need lor training in three broad areas-traditional media, new media, and conceptual areas. While the impact of the new communication technologies on Extension's internal information delivery system has been dramatic, Extension's publics also are reacting to changes in other delivery systems such as cable'television, computers, and VCRs. The changing information environment in which agents currently operate suggests that our traditional communication training efforts may need to be modified. This study found that agents appear to be aware of these changing needs, and rank the need for traditional media training considerably lower than their perceived need for communication training in either new media such as desktop publishing, or conceptual areas such as communication planning and strategies.