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Cultivating Interdisciplinary Shared Wisdom Through a Structured Case Conference
Meredith A MacMartin1,2, Amelia M Cullinan2, Jingyi Zhang1
1Geisel School of Medicine at Dartmouth, Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH, USA.
None:
BackgroundThe interdisciplinary practice of specialty palliative care teams faces complex challenges without clear guidance, especially around collaboration, clinical care, and teaching. Case-based group discussions on communication challenges in clinical care may promote interdisciplinary teams' professional growth and psychological wellbeing.ObjectivesTo develop and understand the impact of a structured, case-based, facilitated discussion of communication challenges on the function and wellbeing of an interdisciplinary specialty palliative care team.MethodsOur palliative care section created an interprofessional case-based conference focused on close examination of communication challenges modeled on "Morning Report", called "Wisdom Wednesday" (WW). Initial components included the clinical background and setting, planned communication strategy, and retelling of the clinical encounter in question. We included discussion of differential diagnoses for communication challenges encountered, and strategies for how to explore the underlying contributing factors and how to find success moving forward. Over time more structure has been developed to guide facilitation and allow for a more diverse facilitation group.ResultsResults from a focus group of 23 palliative care clinicians found that the WW conference facilitated team connection, served as a resource for clinicians facing clinical challenges, and celebrated interprofessional perspectives. A subset of participants expressed a need for additional support to feel confident presenting.ConclusionsEmbedding a weekly facilitated case discussion in the usual practice fostered a virtuous cycle of individual growth and team connectedness among interdisciplinary palliative care providers. Similar conferences could be implemented in other medical teams to teach practical wisdom and reduce burnout.
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