Interprofessional communication of prognosis: teaching to bridge the gaps

The communication of patient prognosis is an essential component of modern healthcare. Previous research has focussed on clinician-to-patient communication only, while the interaction between different professionals in a clinical setting remains relatively unexplored. The research reported here investigated how multidisciplinary clinicians (nursing, medicine and allied health) communicated prognosis information in these professional groups in an acute care setting.

A case series method was utilised with a sample of patients with haematological malignancies in an acute haematology ward in a metropolitan city of Australia. Data were provided by clinician interviews (nursing, medical and allied health) and patient notes. The data were examined in three individual case studies, which were then collectively analysed as an overarching case series.

Thematic analysis of the case series resulted in three major findings for the study. The second finding that 'Clinicians are unprepared to discuss prognosis' was the focus of this paper. Identified barriers to prognosis communication were role delineations and a lack of shared values between disciplines. The state of unpreparedness has serious implications for how members of the staffing groups interact with patients and their families.

Overall, the findings offer support for the need for educational strategies to prepare pre-service health students (future clinicians) to discuss prognosis in clinical settings. Medical, nursing and allied health clinicians tend to discuss prognosis from either a psychosocial or scientific viewpoint. Pre-service health students may benefit from increased communication and teamwork skills, familiarity with framing devices to understand and discuss prognosis and increased understanding of the roles and values of other health professions, in order to bridge communication gaps.