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27 ‘i don’t know what to say’: communication at the end of life – workshops for foundation doctors
  1. Beverley Lee,
  2. Amy Pharaoh,
  3. Andi Stone and
  4. Claire MacLachlan
  1. Forest Holme Hospice, Poole Hospital NHS Foundation Trust


Background Effective Communication skills are imperative for good patient care. Communication with patients and relatives can be challenging in a busy hospital environment. Juniors have extensive training throughout medical school, but little after qualifying. however, they are often involved in these end of life discussions.

Methods As part of their education programme,all Foundation Year 1 Doctors at Poole Hospital NHS Foundation Trust attend a small group workshop (4–6 participants) facilitated by a Palliative Medicine Consultant and Specialist Nurses in Palliative and End of Life Care. Workshops run every month to allow all 28 FY1 Doctors to attend.

each 3 hour session comprises:

  • Principles of good communication, challenges andindividual experience.

  • Observation of facilitator acted role play

  • individual role play with a nurse actor. peer and facilitator feedback.

Communication scenarios include breaking bad news, DNACPR, ACP and discussing dying.

Evaluation includes questionnaire on completion of the workshop and a follow up 3 months later.

Results in 2016 all 28 (100%) FY1 Doctors attended a workshop. 100% completed a survey on completion of the workshop and 54% completed a follow-up survey at 3 months. Feedback was very positive with 93% rating facilitation as excellent and 7% as very good.

Supportive, constructive, real-time feedback given by approachable, knowledgeable staff was appreciated. FY1 Doctors reported training was not too early after qualifying, giving them opportunity to practice conversations in a relaxed environment and provide skills for the future. Some participants suggested it would be helpful at the start of their post in Medicine for the Elderly.

All Doctors reported gaining confidence in challenging conversations and in particular DNACPR discussions.

Conclusion Foundation Doctors appreciate the opportunity to develop confidence in communication skills at a very early stage in their career. Embedding these skills early can help to improve life-long communication, patient care and reduce complaints.

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