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Related Experiment Video

Updated: Jan 31, 2026

A Training Program Using an Agility Ladder for Community-Dwelling Older Adults

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Published on: March 7, 2020

Using Implementation Science to Adapt a Training Program to Assist Surgeons with High-Stakes Communication.

Lauren J Taylor¹, Sarah Adkins², Andrew W Hoel³

¹Department of Surgery, University of Wisconsin. Madison, Wisconsin.

Journal of Surgical Education

|January 11, 2019

Summary

A new implementation package effectively adapted the Best Case/Worst Case communication tool for surgical residents. This scalable approach enhances end-of-life conversations, despite some recruitment challenges.

Keywords:

Communication Education End-of-life Interpersonal and Communication Skills Patient Care Surgery Systems-Based Practice

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Area of Science:

Medical Education
Communication Skills Training
Implementation Science

Background:

Surgical education lacks formal training for difficult end-of-life patient conversations.
The Best Case/Worst Case communication tool was effective but resource-intensive to train surgeons.
A scalable, lower-resource training package was needed for wider dissemination.

Purpose of the Study:

To develop and test an implementation package for the Best Case/Worst Case communication tool.
To adapt a resource-intensive training for group-learning and wide-scale dissemination.
To assess the feasibility, fidelity, and acceptability of the new training package.

Main Methods:

Utilized the Replicating Effectiveness Programs framework.
Intervention tested with 39 surgical residents across 4 institutions.
Implementation package included instructional video, checklists, and learner/instructor manuals.

Main Results:

Attendance varied (16%-75%), with resident recruitment challenges.
69% of residents completed post-training assessment with a mean score of 12.8/15.
97% of residents agreed the tool improved high-stakes conversations; 100% felt prepared.

Conclusions:

A resource-intensive communication training can be modified for group learning and wide dissemination.
Implementation science enabled adaptation for broader reach.
Identified barriers like feasibility and buy-in for future communication skills training.