Improving Critical Care Communication with the Serious Illness Conversation Guide at an Academic Medical Center

Area of Science:

• Medical Education
• Palliative Care
• Critical Care Medicine

Background:

• Professional societies advocate for enhanced serious illness communication training for critical care professionals.
• The Serious Illness Conversation Guide (SICG) is a recognized tool for outpatient goals-of-care discussions.

Purpose of the Study:

• To assess the suitability and impact of an Intensive Care Unit (ICU)-tailored SICG training program for critical care fellows and faculty.
• To evaluate the effectiveness of the ICU-tailored SICG in improving communication skills and clinical practice.

Main Methods:

• A prospective pre-post single-institution study was conducted at a rural academic medical center.
• Twelve critical care service (CCS) fellows and eight CCS faculty received a one-day ICU-tailored SICG training.
• Fellows' skills were assessed via simulated patient encounters; faculty reported practice changes post-training.

Main Results:

• The ICU-tailored SICG was found suitable for the critical care setting, with six of seven suitability questions showing statistical significance.
• Critical care service fellows demonstrated increased use of SICG components post-training (P = 0.033).
• Critical care service faculty reported implementing the ICU-tailored SICG into their clinical practice within three months.

Conclusions:

• The ICU-tailored Serious Illness Conversation Guide is appropriate for use in critical care settings.
• Training in the ICU-tailored SICG enhances communication skills in fellows and promotes practice change in faculty.
• This intervention supports improved serious illness communication in critical care.