Background In 2013, Alfred Health developed the “Improving End of Life Working Group” to identify and address gaps in service delivery for patients nearing the end of their lives. They identified the need to improve the way doctors discuss treatment options with patients nearing the end of their life who were facing acute medical problems.
Methods We refined a previously developed education program aiming to increase doctors’ skills and confidence in approaching these conversations. The teaching is based around a new paradigm that places less importance on avoiding death, and more importance on understanding the patient, their values, fears and wishes. The course promotes shared decision-making and offering advice.
Results 41 junior medical staff have attended the program, with a maximum number of 16 participants per session. Prior to the course, only 12% of participants felt that they had had adequate training in planning and discussing end of life care with their patients and relatives, and only 14% felt well-equipped to do this. After the course, 100% participants stated that the course would help them discuss end of life care with their patients, has helped them feel more comfortable giving advice about options to patients, and was valuable to their clinical practice.
Discussion/conclusion We have successfully developed and implemented a program of communication skills training which we hope will improve the way medical staff discuss treatment options with patients nearing the end of their lives, and which we hope to roll out to all junior medical staff.
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