A Digital Serious Illness Conversation Coach

项目总结 已经表明，关于临终关怀的对话集中在病人的护理目标上 可以减少心理痛苦和焦虑，提高生活质量，以及 对于患有严重疾病的患者来说，可能会延长生命。重病 对话指南(SICG)是一个经过验证且广泛使用的框架，用于培训关键人员 有效地进行这些对话所需的沟通技能；然而， 目前没有任何机制可以轻松地支持和继续在可扩展的 道路。有证据表明，对话代理，即聊天机器人，可以用于培训和 加强沟通能力建设。在第一阶段SBIR项目中，我们建议优化和 评估旨在加强SICG培训的聊天机器人的可行性和可接受性 医疗保健专业人员(HCP)就发起和进行敏感对话 被诊断患有严重疾病的患者。我们将直接使用HCP开发和测试聊天机器人 他们正在导航严重疾病对话和/或可能会在未来导航。我们 将通过以下方式展示增强聊天机器人原型的可行性和可接受性 以下两个具体目标：在目标1中，我们将创建和改编聊天机器人的内容，并构建一个 增强的、功能齐全的聊天机器人原型，具有专家输入。聊天机器人将有3个特色 不同的患者情况不同，病例复杂程度不一。在目标2中，我们将进行一项试验可用性 具有50个目标终端用户的原型研究--不同角色的HCP的不同样本， 在SICG接受过至少一次培训的专业和职业阶段。 注册后，HCP将独立测试由聊天机器人领导的培训并完成 在3个时间点(基线、终点和注册后1个月)进行调查，以评估 以下结果测量：培训前/培训后对患有严重疾病的信心 对话、可用性和用户满意度。半结构化的终点线面试将是 对15-20个HCP进行有目的的抽样，以收集关于以下方面的额外质量反馈 用户体验和改进建议。这一期SBIR项目的成果 将在潜在的第二阶段工作中提供更大规模的实施研究，以评估 拟议干预措施的效力和成本效益，以加强和扩大 重要的沟通技巧，对重病患者的护理至关重要。

PROJECT SUMMARY It has been shown that conversations on end-of-life care focused on a patient’s goals of care can reduce psychological distress and anxiety and lead to improved quality of life, and potentially prolonged life, for patients living with serious illness. The Serious Illness Conversation Guide (SICG) is a validated and widely used framework for training the critical communication skills needed to effectively conduct these conversations; however, there currently exists no mechanism to easily support and continue to build these skills in a scalable way. Evidence suggests that conversational agents, i.e., chatbots, can be used for training and reinforcing communication skills. In this Phase I SBIR project, we propose to optimize and assess the feasibility and acceptability of a chatbot designed to augment SICG training for healthcare professionals (HCPs) on initiating and conducting sensitive conversations with patients diagnosed with serious illness. We will develop and test a chatbot directly with HCPs who are navigating serious illness conversations and/or may be expected to in the future. We will demonstrate feasibility and acceptability of an enhanced chatbot prototype through the following two specific aims: In Aim 1, we will create and adapt chatbot content and build an enhanced, fully functional prototype of the chatbot with expert inputs. The chatbot will feature 3 different patient scenarios ranging in case complexity. In Aim 2, we will conduct a pilot usability study of the prototype with 50 target end users—a diverse sample of HCPs varying in role, specialty, and career phase who have received at least one training session in the SICG. Following enrollment, HCPs will independently test the chatbot-led training and complete surveys at 3 timepoints—baseline, endline, and 1-month after enrollment—to assess the following outcome measures: pre-/post-training confidence in having serious illness conversations, usability, and user satisfaction. Semi-structured endline interviews will be conducted with a purposive sample of 15-20 HCPs to collect additional qualitative feedback on user experience and recommendations for improvement. Results of this Phase I SBIR project will inform a larger scale implementation study in potential Phase II work to evaluate the effectiveness and cost-effectiveness of the proposed intervention to reinforce and augment critical communication skills essential to the care of seriously ill patients.