• Palliative medicine · Feb 2024

    Review

    Education modalities for serious illness communication training: A scoping review on the impact on clinician behavior and patient outcomes.

    • Melissa Lavecchia, Jeff Myers, Daryl Bainbridge, Nadia Incardona, Oren Levine, Leah Steinberg, Daniel Schep, Joanna Vautour, Shilpa Jyothi Kumar, and Hsien Seow.
    • Division of Gynecologic Oncology, Department of Obstetrics & Gynecology, McMaster University, Hamilton, ON, Canada.
    • Palliat Med. 2024 Feb 1; 38 (2): 170183170-183.

    BackgroundSeveral 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.AimTo examine what is known about the education modalities used in serious illness communication training and their impact on clinician behaviors and patient outcomes.DesignA scoping review using the Joanna Briggs Methods Manual for Scoping Reviews was conducted to examine studies measuring clinician behaviors or patient outcomes.Data SourcesOvid MEDLINE and EMBASE databases were searched for English-language studies published between January 2011 and March 2023.ResultsThe 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.ConclusionThis 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.

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