Adapting the Serious Illness Conversation communication training workshop from the Western to an Asian context in...

The Serious Illness Care Program (SICP) was developed in the United States and consists of three main componentsthe-Serious Illness Conversation Guide (SICG), Serious Illness Conversation (SIC) communication training, and quality improvement system tools like dashboards to track SIC processes and uptake. We anticipated that SIC training would need to be contextualized locally for training to be more effective for local clinicians. Our purpose now is to present our adaptation of the SIC communication training program from the Western to the Asian context.

The adaptation was carried out in three phases. The first phase was a virtual SIC workshop in July 2022; feedback was analysed quantitatively and qualitatively to inform localisation of training methodology. In phase two, we piloted a 1.5-day localised face to face workshop in November 2022; feedback was analysed quantitatively and qualitatively for acceptability. In phase three, ten maintenance runs of local SIC workshops were conducted from March 2023 to May 2024. Feedback from attending healthcare practitioners (HCPs) was analysed quantitatively to evaluate the impact of the workshops on learners over the 26 months.

Forty-six, 38 and 402 HCPs were trained in each phase of the SIC Workshops, respectively. Feedback from phase one indicated the need for context-specific materials for Singapore and enhancement of learning experience through group discussions. This was incorporated in phase two, wherein post-workshop 100% of the participants had increased self-reported knowledge regarding SICs in the local context. Evaluation of the maintenance runs of the local SIC workshops over 26 months demonstrated consistent feedback; six-months after the workshop more than 85% of the respondents had used the SICG in their practice.

As literature on cross-cultural adaptation is scarce, we present a study of the adaptation of a training workshop from the Western context to the Asian context. Adapted workshops were highly rated by participants with increased self-reported knowledge and confidence in the use of the SICG. Our adaptation process offers reflection points for international healthcare settings that are considering scaling their educational programs cross-culturally.