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Short report
‘Difficult Conversations’: evaluation of multiprofessional training
  1. Lisa Jane Brighton1,
  2. Lucy Ellen Selman1,2,
  3. Nicholas Gough3,
  4. JJ Nadicksbernd4,
  5. Katherine Bristowe1,
  6. Catherine Millington-Sanders4,5 and
  7. Jonathan Koffman1
  1. 1 Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King’s College London, London, UK
  2. 2 Population HealthSciences, Bristol Medical School, University of Bristol, Bristol, UK
  3. 3 Department of Palliative Care, Guy’s and Saint Thomas' NHS Foundation Trust, London, UK
  4. 4 Difficult Conversations, London, UK
  5. 5 Kingston Clinical Commissioning Group, Kingston upon Thames, London, UK
  1. Correspondence to Lisa Jane Brighton, Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King’s College London, Bessemer Road, London SE5 9PJ, UK; lisa.brighton{at}kcl.ac.uk

Abstract

Objectives Evidence-based communication skills training for health and social care professionals is essential to improve the care of seriously ill patients and their families. We aimed to evaluate the self-reported impact of ‘Difficult Conversations’, a multidisciplinary half-day interactive workshop, and gain feedback to inform future development and evaluation.

Methods Service evaluation using questionnaire data collected before and immediately after workshops from February 2015 to August 2016 regarding participant self-assessed confidence, knowledge and skills. Qualitative free-text comments provided feedback about the workshop and were subjected to content analysis.

Results Of 886 workshop participants, 655 completed baseline questionnaires and 714 postworkshop questionnaires; 550 were matched pairs. Participants were qualified or trainee general practitioners (34%), community nurses and care coordinators (32%), social care professionals (7%), care home staff (6%), advanced practice/specialist nurses (5%), care workers (5%) and allied health professionals (3%). All groups demonstrated significant increases in mean self-assessed confidence (2.46, 95% CI 2.41 to 2.51; to 3.20, 95% CI 3.17 to 3.24; P<0.001), knowledge (2.22, 95% CI 2.17 to 2.27; to 3.18, 95% CI 3.14 to 3.22; P<0.001) and skills (2.37, 95% CI 2.32 to 2.42; to 3.09, 95% CI 3.05 to 3.12; P<0.001). Qualitative findings showed participants valued role play, the communication framework acronym and opportunities for discussion. They commended workshop facilitators’ skills, the safe atmosphere and interprofessional learning. Suggested improvements included more prepared role play and greater coverage of the taught topics.

Conclusions ‘Difficult Conversations’ workshops were associated with improvements in participants’ self-assessed confidence, knowledge, and skills. Our findings identify workshop characteristics that are acceptable to multidisciplinary trainees. Further testing is warranted to determine effectiveness and accurately identify workshop components leading to change.

  • education
  • communication
  • palliative care
  • end of life
  • health services evaluation

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjspcare-2017-001447

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    Footnotes

    • Contributors JK and CM-S obtained research funding, and all authors contributed to the design of the service evaluation. CM-S and JN collected the data. LJB analysed the data with guidance from JK. LJB and JK led on writing the paper, and LES, NG, JN, KB and CM-S contributed to drafting and critical revision and the manuscript. All approved the final version for publication.

    • Funding This service evaluation was funded by Health Education North West London.

    • Competing interests LJB, LES, NG, KB and JK declare no competing interests. JN and CM-S developed the ‘Difficult Conversations’ workshop and have a small proportion of their time paid by the Social Enterprise Difficult Conversations.

    • Ethics approval This service evaluation was approved for publication by the London Stanmore NHS Research Ethics Committee (ref: 16/LO/1571).

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement Requests for additional data should be directed to the corresponding author.