Featured Research

from universities, journals, and other organizations

Simulation-based communication training does not improve quality of end-of-life care

Date:
December 3, 2013
Source:
The JAMA Network Journals
Summary:
Among internal medicine and nurse practitioner trainees, simulation-based communication skills training compared with usual education did not improve quality of communication about end-of-life care or quality of end-of-life care but was associated with a small increase in patients' symptoms of depression, according to a study.

Among internal medicine and nurse practitioner trainees, simulation-based communication skills training compared with usual education did not improve quality of communication about end-of-life care or quality of end-of-life care but was associated with a small increase in patients' symptoms of depression, according to a study appearing in the December 4 issue of JAMA, a medical education theme issue.

"Observational studies have suggested that communication about end-of-life care is associated with decreased intensity of care, increased quality of life, and improved quality of dying. In addition, interventions that focus on communication about palliative and end-of-life care, using palliative care specialists, have demonstrated improved quality of life, decreased symptoms of depression, and reduced intensity of care at the end of life," according to background information in the article. "Simulation-based training improves skill acquisition, but effects on patient-reported outcomes are unknown."

J. Randall Curtis, M.D., M.P.H., of the University of Washington, Seattle, and colleagues conducted a trial to examine whether a communication skills-building workshop aimed at internal medicine (n = 391) and nurse practitioner (n = 81) trainees, using simulation during which trainees practiced skills associated with palliative and end-of-life care communication, had any effect on patient-, family-, and clinician-reported outcomes. Participants were randomized to the 8-session, simulation-based, communication skills intervention (n = 232) or usual education (n = 240).

The primary outcome was patient-reported quality of communication (QOC). Secondary outcomes were patient-reported quality of end-of-life care (QEOLC) and depressive symptoms and family-reported QOC and QEOLC.

The researchers received 1,866 patient evaluations completed by 1,717 patients evaluating 345 trainees; and 936 surveys completed by 898 family respondents, evaluating 295 trainees. Analysis of the data indicated that the intervention was not associated with improvement in QOC or QEOLC. After adjustment, comparing intervention with control, there was no difference in the QOC or QEOLC score for patients or families, but it was associated with increased depression scores among patients of post-intervention trainees.

"These findings raise questions about skills transfer from simulation training to actual patient care and the adequacy of communication skills assessment," the authors write.

Improving Communication With Patients -- Learning by Doing

In an accompanying editorial, Jeffrey Chi, M.D., and Abraham Verghese, M.D., of the Stanford University School of Medicine, Stanford, Calif., write that there are many possible reasons for the unexpected results of this study.

"Patients and families are not formally trained to evaluate communication skills. Additionally, the acquisition of skills was tested over the course of a 10-month period following workshop participation and not immediately following specific end-of-life discussions. It is possible that the improvement in participants' skills was not enough to make a measurable difference to patients; conversely, it is possible that trainees did not recall training and so were not able to apply the communication skills."

"The study by Curtis et al provides an important lesson about the nature of pedagogy [teaching or training] in medicine: new and innovative ways are needed to teach skills, and continued measurement, reassessment, and validation are needed to determine if those teaching methods have succeeded. The final arbiter is of course the patient and patient outcomes. Much work remains to be done."


Story Source:

The above story is based on materials provided by The JAMA Network Journals. Note: Materials may be edited for content and length.


Journal References:

  1. Jeffrey Chi, Abraham Verghese. Improving Communication With Patients. JAMA, 2013; 310 (21): 2257 DOI: 10.1001/jama.2013.281828
  2. J. Randall Curtis, Anthony L. Back, Dee W. Ford, Lois Downey, Sarah E. Shannon, Ardith Z. Doorenbos, Erin K. Kross, Lynn F. Reinke, Laura C. Feemster, Barbara Edlund, Richard W. Arnold, Kim O’Connor, Ruth A. Engelberg. Effect of Communication Skills Training for Residents and Nurse Practitioners on Quality of Communication With Patients With Serious Illness. JAMA, 2013; 310 (21): 2271 DOI: 10.1001/jama.2013.282081

Cite This Page:

The JAMA Network Journals. "Simulation-based communication training does not improve quality of end-of-life care." ScienceDaily. ScienceDaily, 3 December 2013. <www.sciencedaily.com/releases/2013/12/131203161713.htm>.
The JAMA Network Journals. (2013, December 3). Simulation-based communication training does not improve quality of end-of-life care. ScienceDaily. Retrieved July 30, 2014 from www.sciencedaily.com/releases/2013/12/131203161713.htm
The JAMA Network Journals. "Simulation-based communication training does not improve quality of end-of-life care." ScienceDaily. www.sciencedaily.com/releases/2013/12/131203161713.htm (accessed July 30, 2014).

Share This




More Health & Medicine News

Wednesday, July 30, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Generics Eat Into Pfizer's Sales

Generics Eat Into Pfizer's Sales

Reuters - Business Video Online (July 29, 2014) Pfizer, the world's largest drug maker, cut full-year revenue forecasts because generics could cut into sales of its anti-arthritis drug, Celebrex. Fred Katayama reports. Video provided by Reuters
Powered by NewsLook.com
Nigeria Ups Ebola Stakes on 1st Death

Nigeria Ups Ebola Stakes on 1st Death

Reuters - Business Video Online (July 29, 2014) Nigerian authorities have shut and quarantined a Lagos hospital where a Liberian man died of the Ebola virus, the first recorded case of the highly-infectious disease in Africa's most populous economy. David Pollard reports Video provided by Reuters
Powered by NewsLook.com
Running 5 Minutes A Day Might Add Years To Your Life

Running 5 Minutes A Day Might Add Years To Your Life

Newsy (July 29, 2014) According to a new study, just five minutes of running or jogging a day could add years to your life. Video provided by Newsy
Powered by NewsLook.com
Ebola Outbreak Poses Little Threat To U.S.: CDC

Ebola Outbreak Poses Little Threat To U.S.: CDC

Newsy (July 29, 2014) The Ebola outbreak in West Africa poses little threat to Americans, according to officials with the Centers for Disease Control and Prevention. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins