• Crystal E Brown, Anthony L Back, Dee W Ford, Erin K Kross, Lois Downey, Sarah E Shannon, Curtis J Randall JR 1 Division of Pulmonary and Critical Care, Department of Medicine, Harborview Medical Center, University of Washington, Seattle WA, USA., and Ruth A Engelberg.
• 1 Division of Pulmonary and Critical Care, Department of Medicine, Harborview Medical Center, University of Washington, Seattle WA, USA.
• Am J Hosp Palliat Care. 2018 Jan 1; 35 (1): 45-51.

BackgroundWe conducted a randomized trial of a simulation-based multisession workshop to improve palliative care communication skills (Codetalk). Standardized patient assessments demonstrated improved communication skills for trainees receiving the intervention; however, patient and family assessments failed to demonstrate improvement. This article reports findings from trainees' self-assessments.AimTo examine whether Codetalk resulted in improved self-assessed communication competence by trainees.DesignTrainees were recruited from the University of Washington and the Medical University of South Carolina. Internal medicine residents, medicine subspecialty fellows, nurse practitioner students, or community-based advanced practice nurses were randomized to Codetalk, a simulation-based workshop, or usual education. The outcome measure was self-assessed competence discussing palliative care needs with patients and was assessed at the start and end of the academic year. We used robust linear regression models to predict self-assessed competency, both as a latent construct and as individual indicators, including randomization status and baseline self-assessed competency.ResultsWe randomized 472 trainees to the intervention (n = 232) or usual education (n = 240). The intervention was associated with an improvement in trainee's overall self-assessment of competence in communication skills ( P < .001). The intervention was also associated with an improvement in trainee self-assessments of 3 of the 4 skill-specific indicators-expressing empathy, discussing spiritual issues, and eliciting goals of care.ConclusionSimulation-based communication training was associated with improved self-assessed competency in overall and specific communication skills in this randomized trial. Further research is needed to fully understand the importance and limitations of self-assessed competence in relation to other outcomes of improved communication skill.

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