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Antecedents. Communication skills are critical to establish effective medical interactions, so the importance of teaching them while training of health professionals has become evident. Objective. The present study aimed to analyze the effect of a psycho-educational workshop for medical stu-dents, emphasizing the development of communication skills at five stages of regular medical interviews. Method. Data collected included participants' performance while interviewing simulated patients and writing what they would do with hypothetical cases. The study involved 17 GP-level program medical students in their fourth semester, 12 acted as simulated patients, and nine as supervisors. Participants completed three phases: pretest, treatment, and post-test. The initial and final phases involved applying two tests: Declarative and Active. Results. The largest gain scores occurred for treatment planning and closing stages, followed by general skills. The gain scores obtained in each group of skills in terms of being referred from the workshop contents, and being carried out, showed noticeable consistence. Discussion. Results suggest that teaching communicative skills can improve physicians' interaction with their patients and the care they provide. [ABSTRACT FROM AUTHOR]

The use of face masks during the COVID-19 pandemic presents challenges to communication, with visual and sound barriers impacting the ability to interact effectively. This study evaluated the impact of (1) face masks on communication effectiveness and (2) a communication training program to enhance communication success in an acute hospital setting. A quantitative survey study design was implemented, and staff underwent education on multimodal communication strategies to enhance communication success in masks. Outcomes (staff and patient surveys, communication breakdown audit) were collected at three time points: before and after implementation of the training program and at 6 months. Sixty participants (23 nursing, seven allied health, and 30 patients) were recruited. Prior to training, communication breakdown was frequent (43%), with low staff confidence in communicating in masks. After training and at 6 months, a reduction in communication breakdown was observed (38% and 19%, respectively), with both staff and patients reporting greater confidence communicating in a face mask. Multimodal communication strategies can enhance communication success in face masks in the acute hospital setting. [ABSTRACT FROM AUTHOR]

Copyright of Mediaciones Sociales is the property of Universidad Complutense de Madrid and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Tecnología, Ciencia & Educación is the property of Centro de Estudios Financieros SL and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: The purpose of this study was to survey breast imaging fellowship programs nationally on the state of communication skills training during fellowship training. Methods: In this IRB-exempt study, fellowship program director members of the Society of Breast Imaging (SBI) were anonymously surveyed on current provision and types of communication skills training in their fellowship curricula. Results: A six-question survey was sent to all 95 SBI member fellowship program directors with a response rate of 56% (53/95). Although direct fellow patient-centered communication interactions are practiced across all respondent training programs, formal communication skills training was offered in a minority of programs with 32% (17/53) providing formal communication in the form of a didactic lecture and 17% (9/53) engaging fellows in a simulation communication skills workshop. Of the 53 programs, 12 (22%) reported no formal communication skills training of any kind, while a majority (44/53, 83%) of programs provide regular feedback based on observed fellow-patient communication interactions. Conclusion: Despite nearly uniform practice of engaging breast imaging fellows in direct patient- centered interaction at the onset of the fellowship training year, the majority of fellowship programs do not provide any formal communication skills training curricula at any point during fellowship training. To equip future breast radiologists with the skills to provide value in an increasingly patient-centered field, dedicated formal communication curricula ought to be incorporated consistently into breast imaging fellowship training programs. [ABSTRACT FROM AUTHOR]

Background: Communication among interprofessional healthcare worker teams is critical to ensure a thriving and resilient workforce. We will evaluate the implementation and effectiveness of the Alda Healthcare Experience (AHE), a novel medical improvisation (improv) workshop designed to improve interprofessional communication skills among healthcare professionals. The AHE workshop includes a two-hour experiential training workshop led by an improv specialist and a clinical co-facilitator. In July 2022 we began implementing the AHE workshop by training 18 clinical co-facilitators who will co-facilitate the workshops for 550 healthcare workers from five hospital departments at Stony Brook University Hospital over the course of a year and a half. Using mixed-methods, we will conduct an Effectiveness-Implementation Hybrid Design project that includes an outcome evaluation (effectiveness) and a process evaluation (implementation). Methods: Our outcome evaluation will assess the impact of the AHE workshop on short- and long-term improvement in interprofessional communication, stress, and professional fulfillment. The process evaluation component will examine programmatic, organizational, and individual facilitators or barriers to effective implementation of the AHE workshop. Qualitative methods will include dimensional analysis employing individual interviews of 20–40 AHE Project Participants, 5–10 Selected Informants, and all the clinical co-facilitators. Quantitative methods will use a quasi-experimental longitudinal design with an intervention group and surveillance of a control group (wait-list) and repeated assessments using validated instruments measuring communications skills, professional fulfillment, stress, burnout, uncertainty tolerance, and teamwork. Discussion: Effective and efficient communication within healthcare teams is fundamental to building team cohesion that, in turn, supports individual resilience and builds positive organizational culture. The AHE program is an innovative approach to improve interprofessional healthcare communication and reduce healthcare worker burnout. In addition to institutional buy-in, rigorous evaluations of medical improv programs are necessary as a critical step in making such programs scalable. Trial registration: N/A [ABSTRACT FROM AUTHOR]

Background: Care decision discussions are intended to align treatment with the patient's wishes, goals and values. To overcome the numerous barriers to such discussions, physicians as well as patients need tailored support. We evaluate the effect of a physicians' training and a conversation aid for patients about care decisions on patient and physician outcomes. Methods: At the internal medicine outpatient clinic of the University Medical Centre Utrecht, a 1:1 randomized, parallel-group study (patient conversation aid) was combined with a pre-post intervention (physicians' training) design. Primary outcome was patient satisfaction, secondary outcomes were patient-doctor relationship, shared-decision-making, doctor preparedness and patient appreciation of the conversation aid. Results: Between October 2018 and February 2020 11 physicians (36% residents, 73% female) and 185 patients (median age 58 years (interquartile range (IQR) 50–68), 60% male) participated. Only 28% of the patients reported a care decision discussion during the consultation. We found no effect of the interventions on patient satisfaction (effect sizes -0.14 (95% confidence interval (CI) -0.56–0.27) for conversation aid; 0.04 (95% CI -0.40–0.48) for physician's training), nor on the patient-doctor relationship or shared-decision-making. However, physicians felt more prepared to discuss care decisions after training (median 3 (IQR 1–4) vs 1 (IQR 0–3), p = 0.015). Patients assessed the conversation aid informative and gave an overall mark of median 7 (IQR 7–8). Conclusions: First steps towards fruitful discussions about care decisions were made: patients considered the conversation aid informative and physicians felt better prepared to discuss care decisions after training. The low number of care decision conversations patients reported shows exactly how important it is to focus on interventions that facilitate these discussions, for both the patient and physician. Further work needs to be done to establish the best way to empower patients and physicians. Trial registration: Dutch trial register, trial 6998 (NTR 7188), registered 04/05/2018, https://www.trialregister.nl/trial/6998. [ABSTRACT FROM AUTHOR]

Medical improvisation is an innovative approach to train healthcare professionals in effective communication. The success of this type of training depends on the active engagement of participants. A total of 136 interprofessional healthcare workers completed surveys before and after a two-hour medical improvisation communication training session in October 2020. We investigated individual- and program-level contributors to participation outputs (e.g. engagement and experience). 97% of healthcare professionals in the participating department took part in the training. 82% described the training in positive terms or as a learning experience. Younger participants, medical doctors, and those who had difficulty tolerating uncertainty were less excited than others about training. Their engagement was associated with their excitement and group size. Uncertainty tolerance predicted engagement via a full mediation of excitement. Building excitement, reducing uncertainty about training, and capping group size are likely to improve participant's engagement and experience and will inform dissemination and implementation efforts. [ABSTRACT FROM AUTHOR]

Background: Empathic communication skills have a growing presence in graduate medical education to empower trainees in serious illness communication. Objective: Evaluate the impact, feasibility, and acceptability of a shared communication training intervention for residents of different specialties. Design: A randomized controlled study of standard education v. our empathic communication skills-building intervention: VitalTalk-powered workshop and formative bedside feedback using a validated observable behavioral checklist. Setting/Subjects: During the 2018?2019 academic year, our intervention was implemented at a large single-academic medical center in the United States involving 149 internal medicine and general surgery residents. Measurements: Impact outcomes included observable communication skills measured in standardized patient encounters (SPEs), and self-reported communication confidence and burnout collected by surveys. Analyses included descriptive and inferential statistics, including independent and paired t tests and multiple regression model to predict post-SPE performance. Results: Of residents randomized to the intervention, 96% (n?=?71/74) completed the VitalTalk-powered workshop and 42% (n?=?30/71) of those residents completed the formative bedside feedback. The intervention demonstrated a 33% increase of observable behaviors (p?0.001) with improvement in all eight skill categories, compared with the control who only showed improvement in five. Intervention residents demonstrated improved confidence in performing all elicited communication skills such as express empathy, elicit values, and manage uncertainty (p?

Introduction: Communication skills are an important component in building a good doctor − patient relationship. Imparting knowledge on it to medical students, during their formative years of training, help to overcome issues that arise due to communication gaps with patients. Materials and Methods: Twenty-four 1st-year postgraduate resident doctors in the department of medicine in a tertiary care teaching hospital were evaluated regarding their communication skills. Residents were taught how to communicate properly with patients when taking their informed consent prior to a procedure. Results: Competency of residents and patient satisfaction, evaluated using the Kalamazoo Essential Elements Communication Checklist and Interview Satisfaction Questionnaire, respectively, showed improvements following such training. Conclusion: Formal assessments and training in communication skills for medical residents aid significantly to improve physician competence and patient satisfaction.

Abstract Introduction Exposure to patient death places healthcare workers at increased risk for burnout and traumatic stress, yet limited data exist exploring exposure to death among emergency medical services (EMS) clinicians. Our objective was to describe changes in EMS encounters involving on‐scene death from 2018 to 2021. Methods We retrospectively analyzed deidentified EMS records for 9‐1‐1 responses from the ESO Data Collaborative from 2018 to 2021. We identified cases where patient dispositions of death on scene, with or without attempted resuscitation, and without EMS transport. A non‐parametric test of trend was used to assess for monotonic increase in agency‐level encounters involving on‐scene death and the proportion of EMS clinicians exposed to ≥1 on‐scene death. Results We analyzed records from 1109 EMS agencies. These agencies responded to 4,286,976 calls in 2018, 5,097,920 calls in 2019, 4,939,651 calls in 2020, and 5,347,340 calls in 2021.The total number of encounters with death on scene rose from 49,802 in 2018 to 60,542 in 2019 to 76,535 in 2020 and 80,388 in 2021. Agency‐level annual counts of encounters involving death on scene rose from a median of 14 (interquartile range [IQR], 4–40) in 2018 to 2023 (IQR, 6–63) in 2021 (P‐trend < 0.001). In 2018, 56% of EMS clinicians responded to a call with death on scene, and this number rose to 63% of EMS clinicians in 2021 (P‐trend < 0.001). Conclusion From 2018 to 2021, EMS clinicians were increasingly exposed to death. This trend may be driven by COVID‐19 and its effects on the healthcare system and reinforces the need for evidence‐based death notification training to support EMS clinicians.

Objective: We describe the development and pilot test of a physician-focused, web-based training module designed to improve physician communication related to clinical trials in a diverse cancer patient population. Methods: Researchers and stakeholders developed the training module, which included a video explaining patient-centered communication strategies for discussing trials, and re-enactments of actual clinical interactions. For the pilot test, the module was provided to physician participants in the Partnering Around Cancer Clinical Trials (PACCT) trial at two major urban cancer centers. Questionnaires assessed change in beliefs, behavioral attitudes, knowledge and comfort; and perceptions of the module. Results: Nineteen physicians participated in the pilot test. Most were experienced in discussing trials. Assessments of change were mixed regarding beliefs; they showed marginal improvement in attitudes, and significant improvement in knowledge, but no change in comfort. Feedback on the module was favorable. Conclusions: This stakeholder-developed physician communication training module was acceptable and effective, albeit in this small and highly-experienced physician sample. Future research should determine its effectiveness on communication in clinical settings. Innovation: This is the first physician training module to focus on communicating about clinical trials in a diverse patient population. It offers a web-based format and re-enactments of naturally-occurring clinical interactions.Trial Registration Number: NCT02906241

Objective: Participation in qualitative research, particularly analysis of recorded medical dialogue, offers real-time, longitudinal immersion that can strengthen clinical trainee communication skills. The study objective was to explore how qualitative research participation impacts clinical trainees’ self-perceived communication skills development and practice. Methods: In this study, a 17-member multidisciplinary working group of child life specialists, advanced practice providers, undergraduate/medical students, residents, fellows, attending physicians, social scientists, and career researchers with recent qualitative and communication research experience assembled to discuss this topic using a structured discussion guide. Content analysis was used to identify concepts and themes. Results: Three key themes characterizing the impact of qualitative research participation on aspiring clinicians’ communication skills development and practice arose – the 3Cs: (1) Connection, therapeutic alliance, and accompaniment; (2) Clarity and prognostic communication; (3) Compassion, empathy, and understanding. Participants emphasized that qualitative research learning improved their understanding of patient/family lived experiences, preparing them for future clinical encounters, strengthening their emotional intelligence, and promoting self-care, resilience, and professional affirmation. Conclusions: Immersion in clinical communication through participation in qualitative research is an under-utilized resource for supporting clinical trainees in communication skills development. Innovation: The process of collaborative knowledge production through the collective exploration of an a priori question related to group members’ collective experiences is methodologically innovative. Further, re-thinking qualitative research participation as an underutilized educational opportunity is pedagogically novel, and leaders in medical education and qualitative research should collaborate to realize the potential of this teaching tool.

Background: Funding and limited resources are barriers to required training of residents in serious illness conversation (SIC) skills. Objectives: To examine the effectiveness of a low-cost, low-resource (LCLR) SIC training embedded within a required palliative care rotation. Design: Pre–post prospective cohort study design. Setting/Subjects: Second year internal medicine (IM) residents received an LCLR three-hour training in the SIC Guide (SICG) with a single-faculty member and paired-participant practice replacing actors during a required two-week palliative medicine rotation. Measures: SIC competence checklist measured within simulated patient encounters longitudinally. Results: Twenty resident average SIC checklist scores improved from 11 (95% confidence interval [CI] 9–13) at the beginning of rotation to 19 (95% CI 17–20) at the end of rotation and 18 (95% CI 16–20) at six months after the rotation. Conclusions: LCLR SIC training for IM residents significantly increased the sustained use of basic SIC skills, but was less effective for more complex skills. [ABSTRACT FROM AUTHOR]

Aims and Objectives: Current research suggests that communication training programmes for caregivers of people living with dementia can benefit both parties by improving communication, quality of life and stress. Previous reviews in this area focus on mixed samples of formal and informal caregivers. This review aimed to evaluate current research for trainings specifically for informal caregivers, including the research quality and the key training components. Design and Methods: The review followed the PRISMA research reporting checklist. The electronic databases CINAHL, Embase, Medline and Psychinfo and reference lists of included literature were searched for studies relevant to the aims. Of the 45 identified studies, 36 were excluded based on pre‐specified criteria. Nine studies were included in the final review and subject to quality appraisal using the Qualsyst tool. Results: The included studies' programmes averaged 5 to 6 hours in length over four to five sessions, were mostly face to face in both group and individual settings and were developed using various communication and psychological theories. Studies demonstrated variable quality and outcomes, making it difficult to identify optimal components. However, careful consideration of different factors enabled some suggestions for training dose, delivery method, content and outcomes to measure. Conclusions: Communication training programmes can benefit people living with dementia and their informal caregivers in outcomes such as communication skills and quality of life. Suggestions are made on the training components that optimise these benefits. Relevance to clinical practice: Given the clear benefits on outcomes such as quality of life, there is a need for communication trainings to be offered in clinical contexts. However, given the limited pool of variable quality research and lack of accessible manuals, it is unlikely that this is the case. Consolidating and widening the evidence through further research is essential in making these trainings more widely available. [ABSTRACT FROM AUTHOR]

Science communication fellowship programs act as gatekeepers to the skills and opportunities they provide scientists and science communicators. In this role, they may either resist or reproduce inequities present in society at large. We conducted interviews with 25 US-based science communication fellowship directors representing 23 programs to investigate (1) what types of capital these programs provide to fellows and (2) what rules and norms may shape access to these programs. Our results suggest that these programs connect fellows to rich forms of cultural and social capital in the form of experiential learning and mentorships. However, access to these programs is likely shaped by forms of infrastructure, literacy, and community acceptance. Maintaining the status quo in these organizations may not be enough to resist social inequity, and we finish this article with a call for reflexivity and actionable transformation within these programs. [ABSTRACT FROM AUTHOR]

Introduction: Communication skills are an important component in building a good doctor − patient relationship. Imparting knowledge on it to medical students, during their formative years of training, help to overcome issues that arise due to communication gaps with patients. Materials and Methods: Twenty-four 1st-year postgraduate resident doctors in the department of medicine in a tertiary care teaching hospital were evaluated regarding their communication skills. Residents were taught how to communicate properly with patients when taking their informed consent prior to a procedure. Results: Competency of residents and patient satisfaction, evaluated using the Kalamazoo Essential Elements Communication Checklist and Interview Satisfaction Questionnaire, respectively, showed improvements following such training. Conclusion: Formal assessments and training in communication skills for medical residents aid significantly to improve physician competence and patient satisfaction. [ABSTRACT FROM AUTHOR]

Many factors influence resident physician communication, including rigorous training demands that can contribute to professionalism issues or burnout. The University of Rochester Physician Communication Coaching program launched for attendings in 2011, and expanded to residency programs within 11 clinical departments of our institution. In this model, psychologists serve as coaches, drawing on their expertise in communication skills, behavior change, and wellness promotion. These coaches conduct real-time observation of patient encounters, coding communication with an expanded Cambridge-Calgary Patient-Centered Observational Checklist. Residents receive a written report with individualized feedback. From 2013 to 2020, 279 residents were coached. Since 2018, residents have been formally surveyed for feedback (n = 70 surveys completed; 61% response rate), with 97% rating the experience Very Helpful or Helpful. Of the 70 completed surveys, 54 (77%) included qualitative feedback that has also been positive. Due to the feasibility and growing demand for communication coaching from other residency and fellowship programs, in 2018 two authors (SM and LD-R) developed a 2-year, part-time program to train communication coaches. [ABSTRACT FROM AUTHOR]

Training to enhance healthcare practitioners’ capabilities in engaging people in sensitive and end-of life-related conversations is in demand. However, evaluations have either not measured, or found very limited impact on actual practice and patient experience. Training effectiveness is improved when it is based on in-depth evidence, reflects the complexity of real-life interactions, and instils principles adaptable to everyday practice. A relatively new source of in-depth evidence and practice-relevant insights on healthcare interactions is conversation analytic research, a form of observational analysis of real-life interactions. However, conversation analytic research findings have largely been disseminated by and for scientists, rather than clinicians and trainers. We used conversation analytic evidence to develop resources for use by healthcare trainers. The aim was to increase training’s evidence-base and authenticity. We further aimed to develop resources applicable to working with learners ranging from novices to advanced practitioners. Methods: Using an intervention development approach, we created online video-clips and supplementary written materials for professionals who deliver training, supervision, and support in healthcare communication for staff and students. The materials were reviewed by an advisory group comprising clinicians, lay consultees, educators, and researchers, and piloted by trainers in UK universities, NHS organisations and independent hospices. We refined materials based on their feedback. Results: The resulting ‘RealTalk’ resources focus on practices for communicating with patients and their companions about end-of-life and prognosis. Two core training modules were developed, each comprising several patient case studies featuring video-clips from real-life healthcare consultations. The clips featured practices that patients and experienced practitioners use in approaching end-of-life matters. The case studies also included evidence-based descriptions of observable practices and the principles underlying these, alongside transcripts and case synopses. Conclusions: RealTalk training resources aim to facilitate evidence-based, experiential and reflective learning, focusing on communication challenges, practices and principles for end-of-life-related interactions. The resources are designed for use by trainers for delivering all levels of training, from introductory to advanced, in both formal and informal training settings. Our development process may serve as a blueprint for the production of future evidence-based training resources based on conversation analytic research. [ABSTRACT FROM AUTHOR]

Objective: Explore how often, when and how care decisions are discussed during consultations at an internal medicine outpatient clinic, and what we can learn from these observations.Methods: Qualitative analysis of 150 video-taped consultations. Consultations involving a discussion of care decisions were analyzed using conversation analysis.Results: 1) Only 21 of the 150 consultations involved a discussion of care decisions; 2) As there is no destined phase for the introduction of the topic of care decisions, the topic is most often introduced at the end of the phase 'treatment and course of the disease'; 3) A lot of interactional effort is needed to create common ground and make relevance clear with extensive justification. Hesitation markers, repairs and hypothetical talk show the precariousness of the topic.Conclusions: Three dilemma's need to be addressed: 1) a slot has to be created to introduce the topic of care decisions; 2) common ground has to be created, possibly over time; 3) the paradox of framing the topic as relevant 'in the future' but 'needs to be discussed now' needs to be attended to.Practice Implications: We recommend that physician training should address the three dilemmas. Future research should focus on how to do so. [ABSTRACT FROM AUTHOR]

The objective structured clinical examination (OSCE) is among validated approaches used to assess clinical competence through structured and practical evaluation. Most studies of OSCE have used standardized patients (SPs). However, to our knowledge, there is limited information regarding the specific communication skills enhanced by providing communication training (CT) with SPs. Recently, an artificial intelligence (AI) technology was developed. The aim of this study was to evaluate the experience and outcomes of CT with SPs and impact of using AI for this training. This study targeted fourth-year students participating in a pre-learning course for pharmacy practice experience offered at a Japanese university in 2020. The ENcode, Decode, Control, and REgulate model, which evaluates 24 communication skills, was utilized as a questionnaire-based survey. The survey was conducted prior to CT, following CT, and after a second CT session six weeks later with AI. Seven skills, namely "desire suppression," "expectation acceptance," "facial expression," "emotional communication," "dominance," "maintaining relationships," and "dealing with disagreements," were enhanced by the CT with SPs. These skills were included in the broad categories of "management" and "expression" skills. They were not significantly enhanced by following AI training. However, differences observed between the students who underwent AI training and those who did not demonstrated a positive effect in almost all skills, suggesting that AI training can enhance certain skills. CT with SPs enhances students' "management" and "expression" skills. Additionally, AI shows potential for improving the effect of CT. [ABSTRACT FROM AUTHOR]

Public communication is increasingly recognized as a key component in successful natural resource management within government agencies responsible for conservation. However, communication practices and beliefs among government conservation scientists and practitioners are not well studied or understood. Herein, we present the results of a communication survey disseminated to U.S. Fish and Wildlife Service employees working for the agency's Ecological Services program, a program charged with endangered species recovery. We asked respondents about public communication practices and beliefs, and factors that may motivate or discourage participation in public communication activities. Study respondents reported the lowest levels of participation in media-related, one-way communication activities, including writing educational materials and answering media inquiries. Respondents reported most frequently engaging in one-on-one communication with stakeholders. Although our results suggest that respondents engage in frequent communication with stakeholders, our results also suggest that they mostly communicate with stakeholders remotely, and especially by email, rather than in person. Furthermore, only 36% reported that they go out of their way to visit people in communities. On the other hand, a majority agreed that they learn new things about species and landscapes (80%) from conversations with stakeholders and often use this knowledge to solve conservation problems (89%). With respect to factors that encourage and discourage participation, 93% of respondents indicated that a desire to produce better conservation outcomes motivates them to communicate with stakeholders and the public. Many agreed that a lack of time was an obstacle to participating in public communication (68%), but an even larger majority (86%) indicated that public unfamiliarity with the U.S. Fish and Wildlife Service presented a barrier to public communication. Similarly, a majority of employees agreed that public and stakeholder unfamiliarity with themselves and their work also presented a communication barrier (62%). Our findings suggest that agencies responsible for conservation may want to assess whether the agency and its employees adequately invest in communication activities that foster public familiarity. [ABSTRACT FROM AUTHOR]

Abstract Health professions education has benefitted from standardized patient (SP) programs to develop and refine communication and interpersonal skills in trainees. Effective case design is essential to ensure an SP encounter successfully meets learning objectives that are focused on communication skills. Creative, well-designed case scenarios offer learners the opportunity to engage in complex patient encounters, while challenging them to address the personal and emotional contexts in which their patients are situated. Therefore, prior to considering the practical execution of the patient encounter, educators will first need a clear and structured strategy for writing, organizing, and developing cases. The authors reflect on lessons learned in developing standardized patient-based cases to train learners to communicate to patients during times of diagnostic uncertainty, and provide suggestions to develop a set of simulation cases that are both standardized and diverse. Key steps and workflow processes that can assist educators with case design are introduced. The authors review the need to increase awareness of and mitigate existing norms and implicit biases, while maximizing variation in patient diversity. Opportunities to leverage the breadth of emotional dispositions of the SP and the affective domain of a clinical encounter are also discussed as a means to guide future case development and maximize the value of a case for its respective learning outcomes.

Abstract Background Calls to emergency medical lines are an essential component in the chain of survival. Operators make critical decisions based on information they elicit from callers. Although smooth cooperation is necessary, the field lacks evidence-based guidelines for how to achieve it while adhering to strict parameters of index-driven questioning. We aimed to evaluate the effect of a training intervention for emergency medical operators at a call centre in Tønsberg, Norway. The course was designed to enhance operators’ communication skills for smoothing cooperation with callers. Methods Calls were analyzed using inductively developed coding based on the course rationale and content. To evaluate whether the course generated consolidated behavioral change in everyday practice, the independent analyst evaluated 32 calls, selected randomly from eight operators, two calls before and two after course completion. To measure whether skill attainment delayed decision making, we compared the time to the first decision logged by intervention operators to eight control operators. Analysis included 3034 calls: 1375 to intervention operators (T1 = 815; T2 = 560) and 1659 to control operators (T1 = 683; T2 = 976). Results Operators demonstrated improved behaviours on how they greeted the caller (p

Objective: To evaluate a shared decision-making (SDM) intervention in orthopaedic hip and knee osteoarthritis care.Methods: Using a pre- post intervention design study, we tested an intervention, that included a decision aid for patients (ptDA) and a SDM training course for residents in training and orthopaedic surgeons. The theory of planned behaviour was used for intervention development. Primary outcomes included patient reported decisional conflict, SDM, and satisfaction. Secondary outcomes were physicians' attitude and knowledge, and uptake of the ptDA.Results: 317 patients were included. The intervention improved physicians' knowledge about SDM but had no effect on the primary outcomes. 19 eligible patients used the ptDA (17%). SDM was higher for middle educated patients compared to lower educated (mean difference 9.91, p=0.004), patients who saw surgeons instead of residents (mean difference 5.46, p=0.044) and when surgery was chosen and desired by patients compared to situations where surgery was desired but not chosen (mean difference 15.39, p=0.036).Conclusion: Our multifaceted intervention did not improve SDM and ptDA uptake was low.Practice Implications: In orthopaedic hip and knee osteoarthritic care other ways should be explored to successful implement SDM. Since residents received lower SDM scores, special focus should go to this group. [ABSTRACT FROM AUTHOR]

Background: Communication training for healthcare providers is evident in the context of the COVID-19 global pandemic, however training opportunities are not available in countries with limited resources. Objectives: To investigate perceived comfort in communication about end-of-life and palliative care among healthcare providers in Nairobi, Kenya and to evaluate a pilot webinar-based communication training series. Methods: Through a partnership with a research hospital in Nairobi, healthcare providers engaged an online survey to assess perceived comfort in communication and prior educational training in communication. The COMFORT communication model was used to develop and pilot a webinar-based communication training series to meet training needs. Pre-post measures of comfort in communication and post-curriculum evaluation were used to evaluate the webinars. Results: Survey findings from 94 healthcare providers demonstrated that communication training is most needed when patient/family culture is different from provider. Physicians reported less comfort in communication than nurses and other professionals, especially in communication with family about spiritual or religious concerns. Nurses reported more overall training in palliative care communication topics than physicians and other disciplines. The 3-part webinar series increased communication comfort for physicians and nurses, was highly rated, and participants reported that they would recommend COMFORT webinar training to colleagues. Conclusion: Webinar-based platforms for communication training show promise for meeting communication training needs of healthcare providers. [ABSTRACT FROM AUTHOR]

The increasing use of genetic testing for BRCA1/2 and other pathogenic variants in the management of women with breast and ovarian cancer necessitates increased genetic literacy in oncology healthcare professionals. This pilot study aimed to evaluate an online training program to increase genetic literacy and communication skills in Australian oncology healthcare professionals tasked with discussing and coordinating mainstream genetic testing with breast and ovarian cancer patients. A training website with embedded videos was developed. This study assesses the website's acceptability and user-friendliness; suggestions for improvement were also elicited. Oncology healthcare professionals were recruited through relevant professional organisations, invited to the study by email, asked to work through the website and then complete an online questionnaire. Thirty-two oncology healthcare professionals completed the questionnaire after viewing the website. Nearly all participants were satisfied with the information contained in the program (very satisfied: n = 14/32, 44%, satisfied: n = 17/32, 53%, neither satisfied nor dissatisfied: n = 1/32, 3%) and reported that they had gained new skills (n = 29/32, 91%) and had increased confidence (n = 29/31, 94%) in communicating with breast and ovarian cancer patients about genetic testing. More than 93% (28/30) of participants endorsed the online program as clearly presented, informative, relevant and useful. This pilot study demonstrated high feasibility and acceptability of the training program to increase genetic literacy and communication skills in oncology healthcare professionals discussing genetic testing with breast and ovarian cancer patients. Further evidence from a randomised trial is needed to evaluate effects on changing clinical practice, improving patient outcomes, and cost-effectiveness. [ABSTRACT FROM AUTHOR]

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Objective: Clinical empathy has been described as a key component of effective person-centeredness in patient-physician communication. Yet little is known about general practitioner (GP) trainees' experiences and opinions regarding clinical empathy, empathy-education and the development of empathic skills. This study aimed to explore trainees' experiences with clinical empathy during GP training.Methods: This study used focus group interviews. GP trainees at two Dutch universities were approached by e-mail. Focus groups were conducted between April and November 2018. Six focus groups were conducted: two with starting trainees, two with trainees at the end of their first year and two with trainees at the end of their 3 years' training. Two experienced qualitative researchers analyzed the focus groups. During the thematic analysis the differences and similarities between the various stages of education were taken into account and a framework for the identified themes and subthemes was developed.Results: Thirty-five GP trainees took part. Four main themes could be identified. Starting trainees experienced frictions regarding the influence of personal affective reactions on their medical competencies. Trainees at the end of their first year indicated that they reached a balance between empathic involvement and their responsibility to carry out relevant medical tasks, such as following GP guidelines. Trainees at the end of their three years' training recognized the mutual relationship between the development of the behavioral part of clinical empathy and personal growth. All trainees stated that their needs concerning education changed during their GP training and proposed changes to the curriculum.Conclusions: GP trainees face various obstacles in developing empathic skills and behavior. Particularly they mention handling personal affective reactions. Trainees express a clear wish for clinical empathy, in its theoretical as well as its skill and emotional aspects, to play a central role in the curriculum.Practice Implications: More explicit attention to be paid to empathy by embedding theoretical education, explicit attention to skill training and assessment of empathic behavior by patients and supervisors. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Despite the increasing emphasis on the medical curriculum, students' empathy and communication skills decline with time. As students' attitudes and experiences may influence the effectiveness of communication training and their future communication style, this study aimed to evaluate the opinions of last-year medical students on communication skills learning. MATERIAL AND METHODS: Following the fully mixed concurrent equal status design methodology, we invited sixth-year medical students of our university to fill a paper questionnaire with closed and open questions on their perspectives on communication skills learning. RESULTS: Questionnaires were completed by a representative sample of 166 students. The majority of them recognized the importance and benefits of communication training, and the need to increase its significance in the medical curriculum. They noticed that students with low communication skills lack motivation for improvement. Students also underlined the significance of the hidden curriculum, reporting a contrast between communication classes and the behavior of some physicians. Moreover, students less positively inclined towards communication training doubted its effectiveness and importance, suggesting that it should be offered for volunteers. CONCLUSIONS: In order to meet the expectations of students with positive opinions and overcome the lack of motivation or engagement of negatively inclined students, more emphasis should be placed on communication training. Changes in communication training should include increasing its practical character and intensity, emphasizing its importance and benefits, and paying more attention to hidden curriculum aspects. Revisions to the medical school application system should be considered to underline the importance of interpersonal competencies already at the admission stage. [ABSTRACT FROM AUTHOR]

Abstract Background There is widespread agreement about the importance of communication skills training (CST) for healthcare professionals caring for cancer patients. Communication can be effectively learned and improved through specific CST. Existing CSTs have some limitations with regard to transferring the learning to the workplace. The aim of the study is developing, piloting, and preliminarily assessing a CST programme for hospital physicians caring for advanced cancer patients to improve communication competences. Methods This is a Phase 0-I study that follows the Medical Research Council framework; this paper describes the following sections: a literature review on CST, the development of the Teach to Talk training programme (TtT), the development of a procedure for assessing the quality of the implementation process and assessing the feasibility of the implementation process, and the pilot programme. The study was performed at a 900-bed public hospital. The programme was implemented by the Specialized Palliative Care Service. The programme was proposed to 19 physicians from 2 departments. Results The different components of the training course were identified, and a set of quality indicators was developed. The TtT programme was implemented; all the physicians attended the lesson, videos, and role-playing sessions. Only 25% of the physicians participated in the bedside training. It was more challenging to involve Haematology physicians in the programme. Conclusions The programme was completed as established for one of the two departments in which it was piloted. Thus, in spite of the good feedback from the trainees, a re-piloting of a different training program will be developed, considering in particular the bed side component. The program should be tailored on specific communication attitude and believes, probably different between different specialties.

Abstract Background One of the core symptoms of behavioural variant frontotemporal dementia (bvFTD) is the early loss of social cognitive abilities, which has a deteriorating impact on everyday interaction and the quality of dyadic relationships. Marte Meo® (MM) counselling is a video-based intervention that aims to maintain or improve the quality of dyadic relationships. This non-randomized mixed-method study aimed to evaluate the feasibility of the intervention in practice with primary carers of persons with bvFTD as well as the feasibility of a future confirmatory trial. Methods A pilot effect study with a quasi-experimental, one-group, pre-post design and double pre-measurement was conducted. Data were collected at three time points (t0, t1 after 2 weeks, and t2 after 6 weeks) using videography and several measurement instruments. Between t1 and t2, each primary carer received five MM counselling sessions. The outcomes included positive and negative affect, behavioural and psychological symptoms in dementia (BPSD), the interpersonal abilities of the person with dementia, the sensitivity and distress of the primary carers due to BPSD, the manageability of BPSD, the personal goal attainment by means of MM counselling, and the quality of the dyadic relationships. The pilot process evaluation focused on the primary carers’ and the interventionist’s perceived benefits and perceptions of the intervention process using questionnaires and interviews. Results Five dyads were enrolled. Regarding the feasibility of the intervention, MM counselling seems to be appropriate and useful for the target group. Although the recruitment of persons with reliable bvFTD diagnoses was very time consuming and complex, the intervention was well accepted by the dyads, and regarding goal attainment, all carers benefited as much or even more than they expected. The study also showed that the benefits of MM counselling depend on whether the primary carer has accepted his/her relative’s dementia. Regarding the feasibility of a future confirmatory trial, certain outcomes, particularly positive affect, distress due to BPSD, and the quality of the dyadic relationship, seem to be appropriate for describing possible effects. Conclusion Overall, the intervention seems feasible for this target group. A future confirmatory trial should be planned as a multicentre pilot trial with an extension option. Trial registration DRKS00014377 . Registered retrospectively on April 11, 2018.

Objectives: Despite the potential benefits of open communication about possible desires to die for patients receiving palliative care, health professionals tend to avoid such conversations and often interpret desires to die as requests for medical aid in dying. After implementing trainings to foster an open, proactive approach toward desire to die, we requested trained health professionals to lead and document desire to die-conversations with their patients. In this article, we explore how trained health professionals experience an open (proactive) approach to desire to die-conversations with their patients., Methods: Between April 2018 and March 2020, health professionals recorded their conversation-experiences on documentation sheets by answering seven open questions. A subsample was invited to offer deeper insights through semi-structured qualitative interviews. Interviews and documentation sheets were transcribed verbatim and analyzed thematically, then findings from both sources were compared and synthesized., Results: Overall, N = 29 trained health professionals documented N = 81 open desire to die-conversations. A subsample of n = 13 health professionals participated in qualitative interviews. Desire to die-conversations after the training were reported as a complex but overall enriching experience, illustrated in seven themes: (1) beneficial (e.g., establishing good rapport) and (2) hindering aspects (e.g., patients' emotional barriers) of desire to die-conversations, (3) follow-up measures, (4) ways of addressing desire to die, as well as (5) patient reactions to it. The interviews offered space for health professionals to talk about (6) content of desire to die-conversation and (7) (self-)reflection (e.g., on patients' biographies or own performance)., Significance of Results: As part of an open (proactive) approach, desire to die-conversations hold potential for health professionals' (self-)reflection and a deeper understanding of patient background and needs. They may lead to a strengthened health professional-patient relationship and potentially prevent suicide.

Objective: The novel concept of Family-Integrated Care (FICare) requires nurses to be parents' partners in neonatal care. We combined analyses of real-life parent-nurse conversations and interviews to elucidate nurses' role in providing psychosocial support to parents. Findings inform the development of communication training on topicalizing parents' feelings., Methods: Conversation analysis of 15 audio-recorded parent-nurse conversations, and thematic analysis of interviews with 2 nurses., Results: In parent-nurse conversations, nurses showed a "balancing act" in formulating parents' feelings, revealing the complexities of addressing parents' feelings. Overall, parents confirmed nurses' formulations, but also expanded or modified them, or indicated restricted conversational space. In the interviews, nurses discussed four purposes of conversations with parents, emphasizing elaborating on parents' feelings, while discussing associated challenges., Conclusion: Our conversation analysis revealed a continuum of nurses' formulations of parents' feelings, and nurses' reflections illuminated how and when the formulations were used to invite parents' "feelings talk"., Innovation: This study is the first to use conversation analysis to analyze parent-nurse conversations. Additionally, it pioneers combining these analyses with interviews, inviting nurses to reflect on how to incorporate the findings into FICare. This combination strongly informs the development of tailored communication training, drawing from real-life conversations and nurses' articulated needs., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

Introduction: Many of the tasks performed by radiographers rely on effective communication with patients. This study aims to evaluate radiographers' experiences communicating with patients to determine what communication skills they believe they have, challenges they encounter and any familiarity with communication tools. It also assesses their willingness to accept further training and utilise recognised scripted communication tools, such as AIDET (Acknowledge, Introduce, Duration, Explanation and Thank you)., Methods: Data were collected using an online survey deployed using the MS Forms platform. The survey consisted of 42 questions: 12 qualitative 'open-ended' questions and 30 'close-ended' quantitative questions. The survey remained open between March and May 2022. Quantitative data were analysed using descriptive statistics and qualitative responses using thematic content analysis. Cross distribution analysis, basic percentages, and graphic bar charts were used for quantitative data analysis., Results: One hundred and nine radiographers completed the questionnaire. Quantitative analysis found that 84 % (n = 87) of radiographers had not received additional post-qualification training in patient communication. Five communication themes emerged from the thematic analysis; (1) Expectations, (2) Education, (3) Improvements, (4) Errors, and (5) Communication Tools. The scripted communication tool AIDET, according to 86 % (n = 89) of respondents, was perceived to be potential helpful in improving radiographer-patient interactions., Conclusion: Radiographers do not believe they have received adequate training for communicating with patients and would like to receive additional training and education. AIDET could be a useful communication tool as a starting guide for less experienced radiographers. There is a need for further studies that explore the use and effectiveness of scripted communication tools in radiographers' communications skills. In addition, additional post-registration training opportunities need to be available for radiographers in patient communication., (Copyright © 2024. Published by Elsevier Inc.)

Objectives: This study aims to investigate whether stress, depression and emotional competencies can help to predict medical students' attitudes towards communication skills training (CST). Anxiety and negative attitudes towards CST have been shown to be linked. Conversely, emotional competencies (EC) were associated with positive attitudes. Exploring these psycho(patho)logical variables therefore seems to be a promising approach to better understanding, or even modifying, attitudes towards CST.Methods: 179 third year medical students were asked to complete the Communication Skills Attitude Scale (CSAS), the Perceived Stress Scale (PSS), the Montgomery-Asberg Depression Rating Scale Self-assessment (MADRS-S) and the Profile of Emotional Competence (PEC).Results: 168 students completed the entire questionnaire. The stepwise regression model first revealed that, taken together, intrapersonal EC "Utilization" and interpersonal EC "Expression" account for 17% of the variance in positive attitudes. Secondly, taken together, intrapersonal EC "Utilization" and interpersonal EC "Expression" account for 16% of the variance in negative attitudes.Conclusion: The more competent a student is in "Utilization" and "Expression", the more positive attitudes and the less negative attitudes he/she has towards CST. In addition, measuring a large set of bio-psycho-social factors might be a way of capturing more variance in attitudes towards CST.Practice Implications: In the study of variables influencing attitudes towards CST, emotional competencies cannot be ignored. The context of the medical consultation encourages the discussion of various emotions felt by the patient. As educationalists, we should prepare the student for this by integrating the notion of EC within the CST. [ABSTRACT FROM AUTHOR]

Effective communication between healthcare providers (HCPs) and patients is important for HCP well-being, patient engagement, and health outcomes. Yet, HCPs do not receive adequate communication skills training and report feeling unprepared for difficult conversations. A needs assessment of 64 cancer HCP trainees in Toronto, Canada, found that a majority of trainees rated themselves with low competency in communication skills to support patients through difficult conversations, while nearly all rated these skills as important to their practice. A blended multiprofessional communications program was developed including online theoretical learning and reflective practice in addition to in-person simulation with standardised patient actors. Since communication skills mastery is highly unlikely to occur at the termination of a single training program, the goal of the program was to stimulate participants' motivational beliefs about difficult conversations communication skills in order to deepen their commitment to learning and mastery. The motivational beliefs assessed included self-efficacy (self-perceived competence), intent to use techniques learned, and confidence in task mastery. After completing the course, participants' self-perceived competence in dealing with difficult conversations significantly increased by an average of 25 points (p < 0.001) on a rating scale of 1–100 (n = 40). Participants' intent to use techniques did not change significantly and remained high with an overall average of 89 points. After the course, participants rated their confidence in mastering techniques learned at an average score of 71 points. Multiprofessional, simulation-based training is an effective way to improve HCP trainees' motivational beliefs around having difficult conversations. [ABSTRACT FROM AUTHOR]

Background: People with language impairments are at a higher risk of receiving inappropriate or inadequate healthcare, often stemming from ineffective exchanges between patients and healthcare professionals. This study explores a possible factor in such exchanges: the use of collaborative forms of talk in interaction with people with aphasia. Aims: To investigate if and how collaborative forms of talk are used as a conversational resource in healthcare interactions by students and their effects on the acquisition of information from the patient. Methods & Procedures: The transcripts of two simulated healthcare interactions between a man with aphasia and two students (i.e., a nursing student and a speech-language pathology student)were analysed through conversation analysis. The analysis aimed to locate instances of collaborative forms of talk, which included joint productions, acknowledgement tokens, reframing of questions, gesture, laughter and engagement with alternative communication methods. The analysis also tracked the progressivity of the interactions and information checking. Outcomes & Results: The students engaged in a range of collaborative forms of talk, which aided the person with aphasia to participate more fully in conversation. However, some issues arose with progressivity, topic continuity and checking for understanding when turns were left incomplete, no candidate understandings were provided or no repair or joint production sequences were initiated. These occurrences may increase the possibility of misunderstandings or loss of important information. Conclusions & Implications: Communication training should include conversational strategies that help to promote collaboration, focusing on enhancing the ability to perceive, and attend to collaboration requests. Training also should help trainees to find ways to frequently check understanding. [ABSTRACT FROM AUTHOR]

Background: Calls to emergency medical lines are an essential component in the chain of survival. Operators make critical decisions based on information they elicit from callers. Although smooth cooperation is necessary, the field lacks evidence-based guidelines for how to achieve it while adhering to strict parameters of index-driven questioning. We aimed to evaluate the effect of a training intervention for emergency medical operators at a call centre in Tønsberg, Norway. The course was designed to enhance operators' communication skills for smoothing cooperation with callers. Methods: Calls were analyzed using inductively developed coding based on the course rationale and content. To evaluate whether the course generated consolidated behavioral change in everyday practice, the independent analyst evaluated 32 calls, selected randomly from eight operators, two calls before and two after course completion. To measure whether skill attainment delayed decision making, we compared the time to the first decision logged by intervention operators to eight control operators. Analysis included 3034 calls: 1375 to intervention operators (T1 = 815; T2 = 560) and 1659 to control operators (T1 = 683; T2 = 976). Results: Operators demonstrated improved behaviours on how they greeted the caller (p <.001), acknowledged the caller (p <.001), and displayed empathy (p = 0.015). No change was found in the use of open-ended questions and agreeing with the caller. Contrary to expectations, operators who took the course logged first decisions more quickly than the control group (p <.001). Conclusions: This pilot study demonstrated that the training intervention generated behavioural change in these operators, providing justification for scaling up the intervention. [ABSTRACT FROM AUTHOR]

Simulated patients (SPs) are an established resource in medical communication training where they portray patients with medical problems to allow medical students to practice communication skills. The range of skills offered by SPs appears to be underappreciated and there is no formal published research exploring their views on how their skills can best be utilized in experiential teaching sessions. This study aims to fill that research gap. Eighteen SPs from two medical schools, Hull York Medical School and Durham University, were interviewed using an in-depth, one-to-one, semi-structured approach. Data was transcribed verbatim and thematically analysed. Three global themes were identified from the data: (i) the benefits of using simulated patients, (ii) prerequisites and (iii) feedback. Benefits of using SPs include their ability to target specific communication skills in role-play. They can facilitate sessions and give feedback to students; and they enable early communication training in a non-clinical setting. Their key asset is the ability to role-play a realistic patient whilst simultaneously appraising the student's performance and adapting their role to create learning opportunities. We have named this dual approach the two heads of an SP. There are certain essential prerequisites. SPs and tutors need appropriate training. Students should be encouraged to be themselves and engage in consultations. A close SP-tutor relationship is beneficial. For SPs giving feedback to students, a priority is to build student confidence. Views on the use of in-role feedback were polarized. This study explores SPs' views on the skills they offer in medical communication training and how these can be best utilized, providing valuable learning points for medical educators. [ABSTRACT FROM AUTHOR]

The current study reports on an attempt to implement some results from a previous study on natural conversation as a Part of Standard Operating Procedure (SOP) and Communication Training Material for Face to Face Communication in Service Industry. The specific research on natural conversation is Oktarini (2016). That study analyzed a heated complaint sequence of interaction (complaint sequence-in short) between a hotel staff and a guest using Conversation Analysis (CA) (Have, 2007; Sidnell, 2010). It appeared that some of the actions of the hotel staff result in more preferable responses than the others. In terms of resolving the complaint sequence amicably, any actions that lead to calmer guest or formulation of problem, are deemed to be preferred. The current study specifically attempts to, firstly capture the moment by moment of small actions (nudges) (Cf. The Royal Institution, 2015) of the staff that garners preferable responses and vice versa; and secondly, translate those “nudges” as a component of SOP design and Communication Training Material. The framework use to translate staff’s actions into SOP design and training material is Conversation Analysis Role-play Method or CARM (Stokoe, 2014, 2018).

Abstract Background Communication between health care provider and patients in oncology presents challenges. Communication skills training have been frequently developed to address those. Given the complexity of communication training, the choice of outcomes and outcome measures to assess its effectiveness is important. The aim of this paper is to 1) perform a systematic review on outcomes and outcome measures used in evaluations of communication training, 2) discuss specific challenges and 3) provide recommendations for the selection of outcomes in future studies. Methods To identify studies and reviews reporting on the evaluation of communication training for health care professionals in oncology, we searched seven databases (Ovid MEDLINE, CENTRAL, CINAHL, EMBASE, PsychINFO, PsychARTICLES and Web of Science). We extracted outcomes assessed and the respective assessment methods. We held a two-day workshop with experts (n = 16) in communication theory, development and evaluation of generic or cancer-specific communication training and/or outcome measure development to identify and address challenges in the evaluation of communication training in oncology. After the workshop, participants contributed to the development of recommendations addressing those challenges. Results Out of 2181 references, we included 96 publications (33 RCTs, 2 RCT protocols, 4 controlled trials, 36 uncontrolled studies, 21 reviews) in the review. Most frequently used outcomes were participants’ training evaluation, their communication confidence, observed communication skills and patients’ overall satisfaction and anxiety. Outcomes were assessed using questionnaires for participants (57.3%), patients (36.0%) and observations of real (34.7%) and simulated (30.7%) patient encounters. Outcomes and outcome measures varied widely across studies. Experts agreed that outcomes need to be precisely defined and linked with explicit learning objectives of the training. Furthermore, outcomes should be assessed as broadly as possible on different levels (health care professional, patient and interaction level). Conclusions Measuring the effects of training programmes aimed at improving health care professionals’ communication skills presents considerable challenges. Outcomes as well as outcome measures differ widely across studies. We recommended to link outcome assessment to specific learning objectives and to assess outcomes as broadly as possible.

Background and objective: Communication skills are one of the important and effective skills for healthcare providers. Health provider-patient communication is a core component of the health system and has a strong impact on health user satisfaction. This study aimed to explore the level of communication skills among health workforces, and the role of the training course on communication skills improvement. Methods: This quasi-experimental study included 571 newly graduated participants of health workforces from a Sulaimani city center. Standard tools of communication skills were used for pre- and post-test evaluation through 5 hours of training course including 25-30 participants with a total of 24 training courses. Data collection was performed by the self-administered method. Descriptive statistics and analytical statistics were used to test statistical difference and associations. Results: Minimum required for communication knowledge and skills are reported by the small percentage of studied participants (12.6%) at the beginning of training. Comparing the mean scores of communication skills showed a statistically significant improvement (mean difference scores is 5.9) after the intervention. Significant communication skills improvement scores have been reported among youngest age groups and physicians. Conclusion: Well-organized training courses in communication skills can increase the health workforces' rate of communication skills. Training in communication skills should be widely included during undergraduate studying and in-service training programs.

Background: An increasing number of patients to treat combined with a rapidly growing amount of knowledge to integrate, is challenging for future doctors. To take the medical history and diagnose effectively, to send the patient to an expert, to create a relevant expert to expert communication, to discuss with the patient, the time needed for a decision, should be as short as possible. Investigating medical students’ cognitive processes while solving a patient’s case leads to the conclusion that educators should help and facilitate these reasoning and communication processes. Developments in information technology offer a large variety of tools for educators. Method: Practicing repeated memory retrieval in clinically relevant virtual settings leads to more durable storage of theoretical knowledge, especially when applying the theoretical knowledge to meaningful cases. The cases in the present e-learning tool are only solvable when knowledge is coherent, communicated and well-organized, as they demand combination of different interdisciplinary knowledge-fields. Thus, by practicing in the virtual environment, prospective memory (i.e. the ability to remember to do something in the future) is changed and the intention and attention in learning processes is shaped and adapted to the core requirements of clinical practice. Conclusion: Case-based learning can be a promising approach to teach students how to investigate and ask for important information. This paper focuses on undergraduate education and provides an outlook on possible concepts that can be used in different health care sectors.