Communication skills training in advance care planning: a survey among medical students at the University of Antwerp

Abstract

Background Palliative care (PC) is a strongly emerging discipline worldwide. Despite efforts to integrate this important topic in the medical curriculum in Belgium, still little time is spent on PC and its implementation during theoretical and practical training. Materials & methods We had two cohorts of second master’s year MD students at the University of Antwerp complete a survey compromising a custom-built PC knowledge test and a self-confidence assessment of communicative skills used in end-of-life conversations. We evaluated students’ self-confidence regarding end-of-life-conversations before and after a PC training program. We also explored whether the PC classes enabled the students to adequately reflect on factors that might influence end-of-life conversations with an open-end question about the potential implications of the COVID-19 pandemic on advance care planning (ACP) conversations. Finally, we compared the results of the respondents having enjoyed face-to-face training (cohort 1) with those having received online training only (cohort 2, COVID-19 pandemic). Results Although the respondents in both cohorts indicated that the overall curriculum did not pay enough attention to PC training, their average scores on the theoretical questions were good. Feeling confident about their communicative skills in general, they indicated to be less confident when it came to communications concerning PC and ACP in particular. The COVID-19 pandemic was initially equally deemed to impede and facilitate ACP and end-of-life conversations, but after the ACP training class more respondents saw the pandemic as an opportunity to broach end-of-life issues. Finally, we found no differences in scores between online and regular classroom teaching. Conclusion Students experience a lack of confidence in communication skills used in end-of-life conversations and ACP. To help improve skills and competencies in conducting end-of-life conversations, it is recommended to have medical students assess PC/ACP training programs regularly and to modify the curriculum and course content based on these outcomes and current developments.

Do-Not-ResuscitateDecision-Making during the COVID-19 Pandemic in a Teaching Hospital: Lessons Learned for the Future

“…Students at our university experience a lack of confdence in the communication skills used in end-of-life conversations [31]. In this study, looking at everyday practice, we see that especially residents are confronted with determining DNR codes and conducting these conversations.…”

Situation, Education, Innovation, and Recommendation: A Large-Scale Systematic Review of Advance Care Planning in the Age of COVID-19

“…As described above, the need for adequate ACP training for clinicians, identified as a barrier to ACP, was addressed in numerous studies (largely in the Education category) that aimed to encourage ACP engagement through the training of health professionals [ 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 86 , 88 , 89 ]. During the pandemic, enhanced training programs for healthcare professionals have been crucial in equipping them with the skills necessary for effective ACP conversations, including clinical communication skills training and best practice in telehealth/virtual ACP.…”

“…These studies have a strong focus on ACP-related educational interventions that were aimed at practicing healthcare professionals, medical students, and patients and their family members. Education interventions for ACP during the COVID-19 pandemic have proven crucial for both the public and healthcare professionals, as evidenced by a variety of studies within the "education" category [70][71][72][73][74][75]. Training programs have shown a positive impact on the confidence of healthcare providers and students in initiating ACP discussions and recognizing patient cues, despite the challenges presented by social distancing and the need for remote communication [72,84].…”