In-Person and Virtual Adaptation of an Interprofessional Palliative Care Communications Skills Training Course for...

Empathic communication is crucial for clinicians when discussing palliative and end-of-life (PC/EOL) care with parents of children with cancer. Unfortunately, many parents report inadequate communication at these distressing times. This study evaluates the communication skills training (CST) clinicians received to deliver a PC/EOL communication intervention as part of a multi-site randomized-controlled trial (RCT). Training was provided using an in-person format and then adapted to a virtual platform to accommodate remote learners.

Clinicians were trained in dyads (one physician and one nurse [RN] or advanced practice provider [APP]) over 3 days (in-person or virtually). Four pediatric oncology cases were developed and each incorporated three timepoints: diagnosis, disease progression, and end-of life. Training was adapted from VitalTalk^™ and included didactic instruction, videos, visual aids, and role play. Participants completed a confidential, post-training survey. A self-reported quality assurance checklist measured fidelity to the intervention during the RCT.

Thirty clinicians completed training; 26 completed post-training surveys including 46.1% physicians, 30.8% RNs and 23.1% APPs. Most were female (65.4%); white (80.8%), and 40-50 years old (53.9%). Nine (34.6%) trained in-person; the rest trained virtually. Ninety-two percent reported the course was valuable/very valuable for developing PC/EOL communication skills and 96% learned something new. Dyads trained virtually had similar fidelity to those trained in-person (95% and 90% respectively) when delivering the intervention to parents.

This PC/EOL CST, implemented in-person and virtually, was valuable for improving pediatric oncology clinicians' communication skills and was translated effectively into practice.