Background Advance care planning (ACP) is a health behaviour that requires education and support. We developed an outpatient ACP group medical visit model that promotes patient-centred ACP, although the facilitator communication techniques have not been described.
Aim To describe facilitation of an ACP process in novel ACP group medical visits.
Methods Ten cohorts of a 2-session ACP group medical visit model were co-facilitated by a geriatrician and social worker based on an initial guide. Group visit transcripts and patient interviews were analysed qualitatively to explore the facilitator’s role in the ACP process.
Results Analysis of group interactions in ACP group medical visits revealed that facilitators were effectively applying tenets of Collaborative Learning Theory to promote ACP. This theory suggests that learning is a shared and social process; learners are diverse in learning styles and experiences; and individual contexts for applying knowledge are provided alongside factual knowledge. Facilitators leveraged Collaborative Learning Theory by initiating active discussions that included sharing personal ACP experiences; using multiple ACP decision aids (e.g., The Conversation Project, PREPARE videos); and maximising time for participants to ask and answer questions of each other. Identified communication techniques based on Collaborative Learning Theory, like inviting diverse perspectives, were used to develop a revised, theory-informed, facilitator guide.
Discussion Specific facilitator communication techniques used in ACP group medical visits promote peer-based learning and group interaction to promote the ACP process.
Conclusion A revised facilitator guide for ACP group medical visits based on Collaborative Learning Theory can facilitate ACP.
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