The ACA training programme to improve communication between general practitioners and their palliative care patients: development and applicability

Slort, Willemjan; Blankenstein, Annette H.; Wanrooij, B. S.; Horst, Henriëtte E. van der; Deliens, Luc

doi:10.1186/1472-684x-11-9

Cited by 11 publications

(13 citation statements)

References 28 publications

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“…While PHCTs and CME providers call for explicit and repetitive training in communication, GPs prefer to develop their own ways of communication through experience rather than through training sessions. The latter contrasts with the literature, which refers to the positive effects of training on doctors’ communication and promotes interactive training sessions [38,39]. This might be due to the GPs’ reluctance to engage in role-play sessions [40].…”

Section: Discussionmentioning

confidence: 96%

Health care professionals’ perceptions towards lifelong learning in palliative care for general practitioners: a focus group study

et al. 2014

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BackgroundThere is a growing need for palliative care. The majority of palliative patients prefer their general practitioner (GP) to organize their palliative home care. General practitioners need a range of competences to perform this task. However, there has been no general description so far of how GPs keep these competences up-to-date. The present study explores current experiences, views and preferences towards training and education in palliative care among GPs, palliative home-care professionals and professionals from organizations who provide training and education.MethodsFive focus groups were brought together in Belgium, with a total of 29 participants, including members of the three categories mentioned above. They were analysed using a constant comparison method.ResultsThe analysis revealed that undergraduate education and continuing medical education (CME) while in practice, is insufficient to prepare GPs for their palliative work. Workplace learning (WPL) through collaboration with specialized palliative home-care nurses seems to be a valuable alternative.ConclusionsThe effectiveness of undergraduate education might be enhanced by adding practical experience. Providers of continuing medical education should look to organize interactive, practice-based and interprofessional sessions. Therefore, teachers need to be trained to run small group discussions. In order to optimize workplace learning, health care professionals should be trained to monitor each other’s practice and to provide effective feedback. Further research is needed to clarify which aspects of interprofessional teamwork (e.g. professional hierarchy, agreements on tasks and responsibilities) influence the effectiveness of workplace learning.

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Section: Discussionmentioning

confidence: 96%

Health care professionals’ perceptions towards lifelong learning in palliative care for general practitioners: a focus group study

et al. 2014

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“…Our intervention largely meets the recommendations for communication skills training in oncology as formulated at a recent consensus meeting by Stiefel et al [23]. Both educational approach and content of the intervention are evidence-based [14]. The outcomes of our trial were based on behavioural observations of simulated GP-patient consultations assessed by a validated quantitative instrument (RIAS).…”

Section: Discussionmentioning

confidence: 99%

“…The development of the ACA training programme has been reported elsewhere [14]. The programme consists of eight steps (see Table 1) and is supported by the ACA checklist (see Table 2).…”

Section: Methodsmentioning

confidence: 99%

“…This programme, focusing on availability of the GP for the patient, current issues the GP should discuss with the patient, and anticipation by the GP of various scenarios (ACA), appeared to be applicable to GPs and GP trainees (see Tables 1 and 2) [14]. In this paper we report on a controlled clinical trial which evaluated the effectiveness of this ACA training programme on GP-patient communication in palliative care.…”

Section: Introductionmentioning

confidence: 99%

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Effectiveness of the ACA (Availability, Current issues and Anticipation) training programme on GP-patient communication in palliative care; a controlled trial

et al. 2013

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BackgroundCommunicating effectively with palliative care patients has been acknowledged to be somewhat difficult, but little is known about the effect that training general practitioners (GPs) in specific elements of communication in palliative care might have. We hypothesized that GPs exposed to a new training programme in GP-patient communication in palliative care focusing on availability of the GP for the patient, current issues the GP should discuss with the patient and anticipation by the GP of various scenarios (ACA), would discuss more issues and become more skilled in their communication with palliative care patients.MethodsIn this controlled trial among GPs who attended a two-year Palliative Care Peer Group Training Course in the Netherlands only intervention GPs received the ACA training programme. To evaluate the effect of the programme a content analysis (Roter Interaction Analysis System) was performed of one videotaped 15-minute consultation of each GP with a simulated palliative care patient conducted at baseline, and one at 12 months follow-up. Both how the GP communicated with the patient (‘availability’) and the number of current and anticipated issues the GP discussed with the patient were measured quantitatively. We used linear mixed models and logistic regression models to evaluate between-group differences over time.ResultsSixty-two GPs were assigned to the intervention and 64 to the control group. We found no effect of the ACA training programme on how the GPs communicated with the patient or on the number of issues discussed by GPs with the patient. The total number of issues discussed by the GPs was eight out of 13 before and after the training in both groups.ConclusionThe ACA training programme did not influence how the GPs communicated with the simulated palliative care patient or the number of issues discussed by the GPs in this trial. Further research should evaluate whether this training programme is effective for GPs who do not have a special interest in palliative care and whether studies using outcomes at patient level can provide more insight into the effectiveness of the ACA training programme.Trial registrationCurrent Controlled Trials ISRCTN56722368

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“… 21 To fill this gap, we designed a palliative care communication training programme for GPs, based on the results of recent studies on educational interventions in palliative care and on essential elements of GP–patient communication in palliative care. 8 , 17 , 21 – 23 This training programme focuses on availability of the GP to the patient, current issues the GP should discuss with the patient and anticipation of various scenarios by the GP (Availability, Current issues and Anticipation (ACA)). In an earlier article, we reported on the effects of this programme on GPs’ competence.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of the palliative care ‘Availability, Current issues and Anticipation’ (ACA) communication training programme for general practitioners on patient outcomes: A controlled trial

et al. 2014

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Background:Although communicating effectively with patients receiving palliative care can be difficult, it may contribute to maintaining or enhancing patients’ quality of life. Little is known about the effect of training general practitioners in palliative care–specific communication. We hypothesized that palliative care patients of general practitioners exposed to the ‘Availability, Current issues and Anticipation’ communication training programme would report better outcomes than patients of control general practitioners.Aim:To evaluate the effectiveness of the Availability, Current issues and Anticipation training programme for general practitioners on patient-reported outcomes.Design:In a controlled trial, general practitioners followed the Availability, Current issues and Anticipation programme or were part of the control group. Patients receiving palliative care of participating general practitioners completed the Palliative Care Outcome Scale, the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 15 Palliative, the Rest & Peace Scale, the Patient Satisfaction Questionnaire–III and the Availability, Current issues and Anticipation Scale, at baseline and 12 months follow-up. We analysed differences between groups using linear mixed models. Trial registration: ISRCTN56722368.Setting/participants:General practitioners who attended a 2-year Palliative Care Training Course in the Netherlands.Results:Questionnaire data were available for 145 patients (89 in intervention and 56 in control group). We found no significant differences over time between the intervention and control groups in any of the five outcome measures. Ceiling effects were observed for the Rest & Peace Scale, Patient Satisfaction Questionnaire–III and Availability, Current issues and Anticipation Scale.Conclusion:General practitioner participation in the Availability, Current issues and Anticipation training programme did not have a measurable effect on any of the outcomes investigated. Patients reported high levels of satisfaction with general practitioner care, regardless of group assignment. Future research might focus on general practitioners without special interest in palliative care.

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The ACA training programme to improve communication between general practitioners and their palliative care patients: development and applicability

Cited by 11 publications

References 28 publications

Health care professionals’ perceptions towards lifelong learning in palliative care for general practitioners: a focus group study

Health care professionals’ perceptions towards lifelong learning in palliative care for general practitioners: a focus group study

Effectiveness of the ACA (Availability, Current issues and Anticipation) training programme on GP-patient communication in palliative care; a controlled trial

Effectiveness of the palliative care ‘Availability, Current issues and Anticipation’ (ACA) communication training programme for general practitioners on patient outcomes: A controlled trial

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