Self-Assessment Scores Improve After Simulation-Based Palliative Care Communication Skill Workshops
Self-Assessment Scores Improve After Simulation-Based Palliative Care Communication Skill Workshops
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DOI：
10.1177/1049909116681972
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发表时间：
2018-01-01
影响因子：
1.9
通讯作者：
Engelberg, Ruth A.
中科院分区：
文献类型：
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作者：
Brown, Crystal E.;Back, Anthony L.;Engelberg, Ruth A.
背景：我们进行了一项基于模拟的多期研讨会的随机试验，以提高姑息治疗沟通技能（Codetalk）。标准化的患者评估表明，接受干预的受训者的沟通技巧有所改善;然而，患者和家属的评估未能显示出改善。本文报道了学员自我评估的结果。目的：为了研究Codetalk是否导致学员自我评估的沟通能力的提高。设计：学员从华盛顿大学和南卡罗来纳州医科大学招募。内科住院医师，医学专科研究员，护士执业学生，或以社区为基础的高级实践护士被随机分配到Codetalk，基于模拟的研讨会，或常规教育。结果的措施是自我评估的能力与患者讨论姑息治疗的需要，并在学年开始和结束时进行评估。我们使用了强大的线性回归模型来预测自我评估的能力，无论是作为一个潜在的结构和个人指标，包括随机化状态和基线自我评估的competitive.Results：我们随机472名学员的干预（n = 232）或通常的教育（n = 240）。干预与受训者对沟通能力的总体自我评估的改善有关（P < .001）。干预措施也与学员自我评估的3个4技能特定的indicatorsexpressing同情，讨论精神问题，并引出目标的care.Conclusion：基于模拟的沟通培训与提高自我评估能力的整体和具体的沟通技巧，在这个随机试验。需要进一步的研究，以充分了解自我评估能力的重要性和局限性的关系，提高沟通技巧的其他成果。
Background: We conducted a randomized trial of a simulation-based multisession workshop to improve palliative care communication skills (Codetalk). Standardized patient assessments demonstrated improved communication skills for trainees receiving the intervention; however, patient and family assessments failed to demonstrate improvement. This article reports findings from trainees' self-assessments.Aim: To examine whether Codetalk resulted in improved self-assessed communication competence by trainees.Design: Trainees were recruited from the University of Washington and the Medical University of South Carolina. Internal medicine residents, medicine subspecialty fellows, nurse practitioner students, or community-based advanced practice nurses were randomized to Codetalk, a simulation-based workshop, or usual education. The outcome measure was self-assessed competence discussing palliative care needs with patients and was assessed at the start and end of the academic year. We used robust linear regression models to predict self-assessed competency, both as a latent construct and as individual indicators, including randomization status and baseline self-assessed competency.Results: We randomized 472 trainees to the intervention (n = 232) or usual education (n = 240). The intervention was associated with an improvement in trainee's overall self-assessment of competence in communication skills (P < .001). The intervention was also associated with an improvement in trainee self-assessments of 3 of the 4 skill-specific indicatorsexpressing empathy, discussing spiritual issues, and eliciting goals of care.Conclusion: Simulation-based communication training was associated with improved self-assessed competency in overall and specific communication skills in this randomized trial. Further research is needed to fully understand the importance and limitations of self-assessed competence in relation to other outcomes of improved communication skill.