학술논문
Education modalities for serious illness communication training: A scoping review on the impact on clinician behavior and patient outcomes.
Document Type
Academic Journal
Author
Lavecchia M; Division of Gynecologic Oncology, Department of Obstetrics & Gynecology, McMaster University, Hamilton, ON, Canada.; Myers J; Division of Palliative Care, Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada.; Bainbridge D; Department of Oncology, McMaster University, Hamilton, ON, Canada.; Incardona N; Division of Palliative Care, Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada.; Levine O; Department of Oncology, McMaster University, Hamilton, ON, Canada.; Steinberg L; Division of Palliative Care, Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada.; Schep D; Division of Radiation Oncology, Department of Oncology, McMaster University, Hamilton, ON, Canada.; Vautour J; Department of Oncology, McMaster University, Hamilton, ON, Canada.; Kumar SJ; Department of Oncology, McMaster University, Hamilton, ON, Canada.; Seow H; Department of Oncology, McMaster University, Hamilton, ON, Canada.
Source
Publisher: SAGE Publications Country of Publication: England NLM ID: 8704926 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1477-030X (Electronic) Linking ISSN: 02692163 NLM ISO Abbreviation: Palliat Med Subsets: MEDLINE
Subject
Language
English
Abstract
Background: Several clinician training interventions have been developed in the past decade to address serious illness communication. While numerous studies report on clinician attitudes and confidence, little is reported on individual education modalities and their impact on actual behavior change and patient outcomes.
Aim: To examine what is known about the education modalities used in serious illness communication training and their impact on clinician behaviors and patient outcomes.
Design: A scoping review using the Joanna Briggs Methods Manual for Scoping Reviews was conducted to examine studies measuring clinician behaviors or patient outcomes.
Data Sources: Ovid MEDLINE and EMBASE databases were searched for English-language studies published between January 2011 and March 2023.
Results: The search identified 1317 articles: 76 met inclusion criteria describing 64 unique interventions. Common education modalities used were: single workshop ( n = 29), multiple workshops ( n = 11), single workshop with coaching ( n = 7), and multiple workshops with coaching ( n = 5); though they were inconsistently structured. Studies reporting improved clinician skills tended to be in simulation settings with neither clinical practice nor patient outcomes explored. While some studies reported behavior changes or improved patient outcomes, they did not necessarily confirm improvements in clinician skills. As multiple modalities were commonly used and often embedded within quality improvement initiatives, the impact of individual modalities could not be determined.
Conclusion: This scoping review of serious illness communication interventions found heterogeneity among education modalities used and limited evidence supporting their effectiveness in impacting patient-centered outcomes and long-term clinician skill acquisition. Well-defined educational modalities and consistent measures of behavior change and standard patient-centered outcomes are needed.
Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Aim: To examine what is known about the education modalities used in serious illness communication training and their impact on clinician behaviors and patient outcomes.
Design: A scoping review using the Joanna Briggs Methods Manual for Scoping Reviews was conducted to examine studies measuring clinician behaviors or patient outcomes.
Data Sources: Ovid MEDLINE and EMBASE databases were searched for English-language studies published between January 2011 and March 2023.
Results: The search identified 1317 articles: 76 met inclusion criteria describing 64 unique interventions. Common education modalities used were: single workshop ( n = 29), multiple workshops ( n = 11), single workshop with coaching ( n = 7), and multiple workshops with coaching ( n = 5); though they were inconsistently structured. Studies reporting improved clinician skills tended to be in simulation settings with neither clinical practice nor patient outcomes explored. While some studies reported behavior changes or improved patient outcomes, they did not necessarily confirm improvements in clinician skills. As multiple modalities were commonly used and often embedded within quality improvement initiatives, the impact of individual modalities could not be determined.
Conclusion: This scoping review of serious illness communication interventions found heterogeneity among education modalities used and limited evidence supporting their effectiveness in impacting patient-centered outcomes and long-term clinician skill acquisition. Well-defined educational modalities and consistent measures of behavior change and standard patient-centered outcomes are needed.
Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.