NephroTalk: Evaluation of a Palliative Care Communication Curriculum for Nephrology Fellows

J Pain Symptom Manage. 2018 Nov;56(5):767-773.e2. doi: 10.1016/j.jpainsymman.2018.08.002. Epub 2018 Aug 14.

Abstract

Context: Nephrologists care for a medically complex population that faces difficult decisions around treatment options and end-of-life care. Yet communication training within nephrology fellowship is rare. Prior work suggests that communication training in nephrology can improve perceived preparedness to engage in difficult conversations; however, it is unclear if this training results in improved clinical skills.

Objectives: The primary aim was to evaluate the efficacy of a three-day curriculum for nephrology fellows (NephroTalk) to improve communication skill acquisition for delivering serious news. We also measured self-reported preparedness for three additional communication tasks taught, including goals of care and transitions at end of life.

Methods: Thirty-three first- and second-year fellows from seven academic nephrology programs participated in NephroTalk from 2015 to 2016. Pretraining and post-training encounters to deliver bad news with standardized patients were audiorecorded and evaluated using a modified communication checklist. Fellow experience and self-reported improvement in communication tasks were measured using a five-point Likert scale.

Results: Skill use increased after training for seven of the nine skills measured (P < 0.01). The average number of skills gained after training was 3.6 ± 1.8 skills. With increased communication proficiency, post-training encounters were significantly shorter than pretraining encounters (P = 0.03). Fellows reported improved preparedness to engage in all communication tasks taught in NephroTalk curriculum.

Conclusion: Our findings support NephroTalk as an effective communication skills curriculum for nephrology trainees. Fellows increased their communication skills significantly in delivering bad news leading to more efficient encounters.

Keywords: Communication skills curriculum; nephrology; palliative care.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Clinical Competence
  • Curriculum*
  • Education, Medical, Graduate*
  • Fellowships and Scholarships
  • Female
  • Health Communication*
  • Humans
  • Male
  • Nephrology / education*
  • Palliative Care*