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J Pain Symptom Manage. 2018 Nov;56(5):767-773.e2. doi: 10.1016/j.jpainsymman.2018.08.002. Epub 2018 Aug 14.

NephroTalk: Evaluation of a Palliative Care Communication Curriculum for Nephrology Fellows.

Author information

1
Department of General Medicine, Section of Palliative Care and Medical Ethics, Pittsburgh, Pennsylvania, USA; Division of Renal-Electrolyte, University of Pittsburgh School of Medicine, UPMC Health System, Pittsburgh, Pennsylvania, USA. Electronic address: schelljo@upmc.edu.
2
Nephrology Division, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
3
Kidney Health Research Institute, Geisinger Medical Center, Danville, Pennsylvania, USA.
4
Center for Research on Health Care Data Center, Division of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
5
Department of General Medicine, Section of Palliative Care and Medical Ethics, Pittsburgh, Pennsylvania, USA.
6
Department of General Medicine, Section of Palliative Care and Medical Ethics, Pittsburgh, Pennsylvania, USA; Palliative and Supportive Institute, UPMC Health System, Pittsburgh, Pennsylvania, USA.

Abstract

CONTEXT:

Nephrologists care for a medically complex population that faces difficult decisions around treatment options and end-of-life care. Yet communication training within nephrology fellowship is rare. Prior work suggests that communication training in nephrology can improve perceived preparedness to engage in difficult conversations; however, it is unclear if this training results in improved clinical skills.

OBJECTIVES:

The primary aim was to evaluate the efficacy of a three-day curriculum for nephrology fellows (NephroTalk) to improve communication skill acquisition for delivering serious news. We also measured self-reported preparedness for three additional communication tasks taught, including goals of care and transitions at end of life.

METHODS:

Thirty-three first- and second-year fellows from seven academic nephrology programs participated in NephroTalk from 2015 to 2016. Pretraining and post-training encounters to deliver bad news with standardized patients were audiorecorded and evaluated using a modified communication checklist. Fellow experience and self-reported improvement in communication tasks were measured using a five-point Likert scale.

RESULTS:

Skill use increased after training for seven of the nine skills measured (P < 0.01). The average number of skills gained after training was 3.6 ± 1.8 skills. With increased communication proficiency, post-training encounters were significantly shorter than pretraining encounters (P = 0.03). Fellows reported improved preparedness to engage in all communication tasks taught in NephroTalk curriculum.

CONCLUSION:

Our findings support NephroTalk as an effective communication skills curriculum for nephrology trainees. Fellows increased their communication skills significantly in delivering bad news leading to more efficient encounters.

KEYWORDS:

Communication skills curriculum; nephrology; palliative care

[Indexed for MEDLINE]

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