Teaching effective communication by modeling effective communication: Experiences of a communication coach for clinicians

Pollak, Kathryn I.

doi:10.1016/j.pec.2019.08.024

Cited by 9 publications

(10 citation statements)

References 28 publications

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“…However, our findings also document how emotions influence the decision to be made and therefore can be addressed with advantageous results. According to existing research, this might to a higher degree be accommodated by healthcare professionals with adept communication skills, who are capable of engaging with the patients in focused active listening, exploring the patient's emotional response, by for example catching cues and concerns, and are trained to talk with the patients about both the medical issues and their lives with the disease (Hvidt et al, 2018; Pollak, 2019).…”

Section: Discussionmentioning

confidence: 99%

Patients' experiences of the decision‐making process for clinical trial participation

Gregersen

Birkelund

Wolderslund

et al. 2022

Nursing & Health Sciences

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Clinical decision-making about participating in a clinical trial is a complex process influenced by overwhelming information about prognosis, disease, and treatment options. The study aimed to explore patients' experiences of the decision-making process when patients are presented with the opportunity to participate in a cancer clinical trial and to shed light on how patients experience the health communication, the nurse's role, and the physician's role. A qualitative study design was applied. Nine patients with advanced cancer were interviewed after being informed about their treatment options.Data were analyzed using thematic analysis. The results showed that patients made treatment decisions mainly guided by their emotions and trust in the physician. Furthermore, the physicians had a great impact on the decisions, and the nurse's role was associated with conversations about how to manage life. The study highlights the importance of talking about prognosis and addressing the patient's existential issues, particularly in this context of advanced cancer. The study elucidates a need for healthcare professionals to engage in health communication about life when it is coming to an end.

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Section: Discussionmentioning

confidence: 99%

Patients' experiences of the decision‐making process for clinical trial participation

Gregersen

Birkelund

Wolderslund

et al. 2022

Nursing & Health Sciences

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“…The principal investigator (K.I.P.) developed the coaching intervention that included 3 sessions: a 1:1 didactic session (approximately 30-45 minutes) and 2 feedback sessions reviewing 2 audio-recorded and coded encounters (30 minutes each and approximately 1.75 hours each, respectively). Cardiologists audio recorded 2 of their challenging encounters.…”

Section: Methodsmentioning

confidence: 99%

“…Clinicians can learn effective communication via face-to-face courses and interactive computer programs that include practice and tailored feedback . Communication coaching shows signals for improving communication, patient satisfaction, and clinician burnout . However, studies have been small, nonrandomized, and lacked objective assessments.…”

Section: Introductionmentioning

confidence: 99%

Effect of a Coaching Intervention to Improve Cardiologist Communication

et al. 2023

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ImportanceCommunication between cardiologists and patients can significantly affect patient comprehension, adherence, and satisfaction. To our knowledge, a coaching intervention to improve cardiologist communication has not been tested.ObjectiveTo evaluate the effect of a communication coaching intervention to teach evidence-based communication skills to cardiologists.Design, Setting, and ParticipantsThis 2-arm randomized clinical trial was performed at outpatient cardiology clinics at an academic medical center and affiliated community clinics, and from February 2019 through March 2020 recruited 40 cardiologists and audio recorded 161 patients in the preintervention phase and 240 in the postintervention phase. Data analysis was performed from March 2022 to January 2023.InterventionsHalf of the cardiologists were randomized to receive a coaching intervention that involved three 1:1 sessions, 2 of which included feedback on their audio-recorded encounters. Communication coaches taught 5 skills derived from motivational interviewing: (1) sitting down and making eye contact with all in the room, (2) open-ended questions, (3) reflective statements, (4) empathic statements, and (5) “What questions do you have?”Main Outcomes and MeasuresCoders unaware of study arm coded these behaviors in the preintervention and postintervention audio-recorded encounters (objective communication). Patients completed a survey after the visit to report perceptions of communication quality (subjective communication).ResultsAnalysis included 40 cardiologists (mean [SD] age, 47 [9] years; 7 female and 33 male) and 240 patients in the postintervention phase (mean [SD] age, 58 [15] years; 122 female, 118 male). When controlling for preintervention behaviors, cardiologists in the intervention vs control arm were more likely to make empathic statements (intervention: 52 of 117 [44%] vs control: 31 of 113 [27%]; P = .05); to ask, “What questions do you have?” (26 of 117 [22%] vs 6 of 113 [5%]; P = .002); and to respond with empathy when patients expressed negative emotions (mean ratio of empathic responses to empathic opportunities, 0.50 vs 0.20; P = .004). These effects did not vary based on patient or cardiologist race or sex. We found no arm differences for open-ended questions or reflective statements and were unable to assess differences in patient ratings due to ceiling effects.Conclusions and RelevanceIn this randomized clinical trial, a communication coaching intervention improved 2 key communication behaviors: expressing empathy and eliciting questions. Empathic communication is a harder-level skill that may improve the patient experience and information comprehension. Future work should explore how best to assess the effect of communication coaching on patient perceptions of care and clinical outcomes and determine its effectiveness in larger, more diverse samples of cardiologists.Trial RegistrationClinicalTrials.gov Identifier: NCT03464110

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“…Where appropriate, reaffirming statements can be combined with 'wish' statements, such as 'I wish I didn't have to say this', or 'I wish things were different'. 23 Managing challenging issues…”

Section: Reaffirm Emotionsmentioning

confidence: 99%

UK consensus guidelines for the delivery of unexpected news in obstetric ultrasound: The ASCKS framework

et al. 2020

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Background Studies indicate there is a need to improve the delivery of unexpected news via obstetric ultrasound, but there have been few advances in this area. One factor preventing improvement has been a lack of consensus regarding the appropriate phrases and behaviours which sonographers and ultrasound practitioners should use in these situations. Aims To develop consensus guidelines for unexpected news delivery in Early Pregnancy Unit and Fetal Anomaly Screening Programme NHS settings. Methods A workshop was conducted to identify priorities and reach consensus on areas of contention. Contributors included interdisciplinary healthcare professionals, policy experts, representatives from third-sector organisations, lay experts and academic researchers ( n = 28). Written and verbal feedback was used to draft initial guidance which was then circulated amongst the wider writing group ( n = 39). Revisions were undertaken until consensus was reached. Results Consensus guidelines were developed outlining the behaviours and phrases which should be used during scans where unexpected findings are identified. Specific recommendations included that: honest and clear communication should be prioritised, even with uncertain findings; technical terms should be used, but these should be written down together with their lay interpretations; unless expectant parents use other terminology (e.g. ‘foetus’), the term ‘baby’ should be used as a default, even in early pregnancy; at the initial news disclosure, communication should focus on information provision. Expectant parents should not be asked to make decisions during the scan. Conclusions These recommendations can be used to develop and improve news delivery interventions in obstetric ultrasound settings. The full guidelines can be accessed online as supplemental material and at https://doi.org/10.5518/100/24 .

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Teaching effective communication by modeling effective communication: Experiences of a communication coach for clinicians

Cited by 9 publications

References 28 publications

Patients' experiences of the decision‐making process for clinical trial participation

Patients' experiences of the decision‐making process for clinical trial participation

Effect of a Coaching Intervention to Improve Cardiologist Communication

UK consensus guidelines for the delivery of unexpected news in obstetric ultrasound: The ASCKS framework

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