DEVELOPING SKILLS IN COMMUNICATION IN END OF LIFE CARE: EVALUATION OF A 3 DAY PILOT COURSE FOR CORE MEDICAL TRAINING

Abstract

BACKGROUND: Effective communication is a core skill for professionals. Skilled communication is also regarded as one of the key domains of leadership that doctors should develop. Postgraduate training in communication skills is not embedded within training programmes other than GPs. This pilot study examines the feasibility and outcomes of communications skills training for doctors in their Core Medical Training.METHODS: Doctors completed a pre and post training questionnaire at three months to rank, knowledge and understanding of palliative care issues and their confidence in the 'talking and supporting' aspects of end of life care.RESULTS: Dealing with anger & confrontation was the training need identified most. Although some identified the general need to develop skills in 'breaking bad news' or 'discuss sensitive topics', many cited needs in specific scenarios: "Dealing with patients who don't understand the prognosis/or who don't want to know" "Increase in confidence discussing death with patients" "Discussing sensitive topics like DNR (sic) in terminally ill patients" "How to discuss end of life issues without being bogged down by clichés" There was an increase in confidence and knowledge in all areas evaluated in the questionnaire and 86% evaluated the course as very useful and 14% as useful. Trainees valued the way the simulation exercises broke down difficult aspects of communication and the ability to try diverse communication strategies. Rehearsal of a listening approach rather than a defensive approach with 'difficult' patients allowed trainees to feel they had new ideas to utilise within their practice.CONCLUSION: This blended method course was found to be useful and increased confidence in a range of end of life care communication tasks. It may also have promoted an increase in knowledge in other areas of end of life care.