Introduction. Communicating difficult news is a pivotal component of clinical practice. Yet, clinicians are poorly prepared to manage this task. The Program to Enhance Relational and Communication Skills (PERCS), which started in 2002 at Children’s Hospital Boston, offers simulation-based workshops to enhance clinicians’ preparedness to engage in difficult conversations. The aim of this work is to describe the cultural adaptation and implementation of the PERCS Program at San Paolo Hospital, Milan, and to assess the program’s effectiveness. Methods. Since 2008, three Italian PERCS educational programs have been developed focusing on difficult conversations in adult Intensive Care (PERCS-ICU), dialysis (PERCS-Dialysis) and oncology (PERCS-Oncology). The programs feature monthly 4-hour workshops enrolling 10-13 interdisciplinary participants. The workshops were geared around the enactment and debriefing of realistic case scenarios. Participants volunteered to meet with patients/family members portrayed by actors in enacted conversations. The conversations were videotaped in a separate room and showed simultaneously on close-circuit television to the group. After each conversation, participants rejoined the group and had the opportunity to debrief and receive feedback from other participants, actors, and facilitators. Before and after the workshop, participants rated their sense of preparation, communication, relational skills, confidence, and anxiety on 5-point Likert scales. Open-ended questions inquired about lessons learned. T-tests were conducted to determine differences in pre/post ratings. Content analysis was performed on open-ended questions. IRB review was not applicable. Results. 10 workshops were offered (4 PERCS-ICU, 4 PERCS-Dialysis and 2 PERCS-Oncology) enrolling 113 clinicians. Overall, across all three programs, participants reported better preparation (p <.001), confidence (p < .001), and communication skills (p < .001) after the workshop. The workshops had a differential impact depending on the participants’ discipline. Nurses reported improvement in their preparation, confidence, and communication skills, whereas physicians and psychosocial professionals improved in preparation and confidence. Themes from the open-ended questions included: appreciating the learning method; discovering new or pre-existing communication skills; and valuing interdisciplinary collaboration. Discussion/Conclusions. The PERCS learning paradigm based on the use of realistic enactments and interdisciplinary learning, proved logistically adaptable to the Italian healthcare system and effective in improving participants’ preparation, communication skills, and confidence. In Italy, the program had a different impact depending on the discipline. It is possible that the higher self-appraisal of physicians and psychosocial professionals prior to the workshop permitted less room for improvement. Further research is needed to investigate correspondence between self-appraisal and actual clinical practice

The Italian program to enhance relational and communication skills / G. Lamiani, E.C. Meyer, D. Leone, E. Vegni, D.M. Browning, E.A. Rider, R.D. Truog, E. Moja. ((Intervento presentato al 10. convegno International Meeting on Simulation in Healthcare tenutosi a Phoenix nel 2010.

The Italian program to enhance relational and communication skills

G. Lamiani
Primo
;
D. Leone;E. Vegni;E. Moja
Ultimo
2009

Abstract

Introduction. Communicating difficult news is a pivotal component of clinical practice. Yet, clinicians are poorly prepared to manage this task. The Program to Enhance Relational and Communication Skills (PERCS), which started in 2002 at Children’s Hospital Boston, offers simulation-based workshops to enhance clinicians’ preparedness to engage in difficult conversations. The aim of this work is to describe the cultural adaptation and implementation of the PERCS Program at San Paolo Hospital, Milan, and to assess the program’s effectiveness. Methods. Since 2008, three Italian PERCS educational programs have been developed focusing on difficult conversations in adult Intensive Care (PERCS-ICU), dialysis (PERCS-Dialysis) and oncology (PERCS-Oncology). The programs feature monthly 4-hour workshops enrolling 10-13 interdisciplinary participants. The workshops were geared around the enactment and debriefing of realistic case scenarios. Participants volunteered to meet with patients/family members portrayed by actors in enacted conversations. The conversations were videotaped in a separate room and showed simultaneously on close-circuit television to the group. After each conversation, participants rejoined the group and had the opportunity to debrief and receive feedback from other participants, actors, and facilitators. Before and after the workshop, participants rated their sense of preparation, communication, relational skills, confidence, and anxiety on 5-point Likert scales. Open-ended questions inquired about lessons learned. T-tests were conducted to determine differences in pre/post ratings. Content analysis was performed on open-ended questions. IRB review was not applicable. Results. 10 workshops were offered (4 PERCS-ICU, 4 PERCS-Dialysis and 2 PERCS-Oncology) enrolling 113 clinicians. Overall, across all three programs, participants reported better preparation (p <.001), confidence (p < .001), and communication skills (p < .001) after the workshop. The workshops had a differential impact depending on the participants’ discipline. Nurses reported improvement in their preparation, confidence, and communication skills, whereas physicians and psychosocial professionals improved in preparation and confidence. Themes from the open-ended questions included: appreciating the learning method; discovering new or pre-existing communication skills; and valuing interdisciplinary collaboration. Discussion/Conclusions. The PERCS learning paradigm based on the use of realistic enactments and interdisciplinary learning, proved logistically adaptable to the Italian healthcare system and effective in improving participants’ preparation, communication skills, and confidence. In Italy, the program had a different impact depending on the discipline. It is possible that the higher self-appraisal of physicians and psychosocial professionals prior to the workshop permitted less room for improvement. Further research is needed to investigate correspondence between self-appraisal and actual clinical practice
Settore M-PSI/08 - Psicologia Clinica
The Italian program to enhance relational and communication skills / G. Lamiani, E.C. Meyer, D. Leone, E. Vegni, D.M. Browning, E.A. Rider, R.D. Truog, E. Moja. ((Intervento presentato al 10. convegno International Meeting on Simulation in Healthcare tenutosi a Phoenix nel 2010.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/72314
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