Improving residents' end-of-life communication skills with a short retreat: A randomized controlled trial

Journal of Palliative Medicine

Volumn 13, Issue 4, 2010, Pages 439-452

  Szmuilowicz, Eytan ^a,d   El Jawahri, Areej ^b   Chiappetta, Laurel ^c   Kamdar, Mihir ^d   Block, Susan ^d  

^a BRIGHAM AND WOMEN S HOSPITAL   (United States)

^b MASSACHUSETTS GENERAL HOSPITAL   (United States)

^c Data Development Integration Verification and Analysis (DataDIVA)   (United States)

^d DANA FARBER CANCER INSTITUTE   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ADULT; ARTICLE; AUDIO RECORDING; CLINICAL ARTICLE; CLINICAL TRIAL; COMMUNICATION SKILL; CONTROLLED CLINICAL TRIAL; CONTROLLED STUDY; DOCTOR PATIENT RELATION; EMOTION; FEMALE; HUMAN; MALE; MEDICAL PRACTICE; QUESTIONNAIRE; RANDOMIZED CONTROLLED TRIAL; RESIDENCY EDUCATION; TERMINAL CARE;

ADULT; ANALYSIS OF VARIANCE; CLINICAL COMPETENCE; COMMUNICATION; CURRICULUM; EDUCATION; EDUCATIONAL MEASUREMENT; EDUCATIONAL STATUS; FEMALE; HUMANS; ILLINOIS; INTERNAL MEDICINE; INTERNSHIP AND RESIDENCY; MALE; MASSACHUSETTS; PALLIATIVE CARE; PHYSICIAN-PATIENT RELATIONS; PSYCHOMETRICS; QUESTIONNAIRES; TERMINAL CARE; TRUTH DISCLOSURE; UNITED STATES;

EID: 77951781967     PISSN: 10966218     EISSN: None     Source Type: Journal    
DOI: 10.1089/jpm.2009.0262     Document Type: Article

References (84)

1. Hanson LC, Danis M, Garrett J: What is wrong with end-oflife care? Opinions of bereaved family members. J Am Geriatr Soc 1997;45:1339-1344.
2. Steinhauser KE, Christakis NA, Clipp EC, McNeilly M, McIntyre L, Tulsky JA: Factors considered important at the end of life by patients, family, physicians, and other care providers. JAMA 2000;284:2476-2482.
3. Steinhauser KE, Christakis NA, Clipp EC, McNeilly M, Grambow S, Parker J, Tulsky JA: Preparing for the end of life: P of patients, families, physicians, and other care providers. J Pain Symptom Manage 2001;22:727-737.
4. Marvel MK, Epstein RM, Flowers K, Beckman HB: Soliciting the patient's agenda: have we improved? JAMA 1999;281: 283-287.
5. Morita T, Akechi T, Ikenaga M, Kohara H, Mukaiyama T, Nakaho T, Nakashima N, Shima Y, Matsubara T, Fujimori M, Uchitomi Y: Communication about the ending of anticancer treatment and transition to palliative care. Ann Oncol 2004;15:1551-1557.
6. Tulsky JA, Fischer GS, Rose MR, Arnold RM: Opening the black box: How do physicians communicate about advance directives? Ann Intern Med 1998;129:441-449.
7. Butow PN, Brown RF, Cogar S, Tattersall MH, Dunn SM: Oncologists' reactions to cancer patients' verbal cues. Psychooncology 2002;11:47-58.
8. Suchman AL, Markakis K, Beckman HB, Frankel R: A model of empathic communication in the medical interview. JAMA 1997;277:678-682.
9. Levinson W, Gorawara-Bhat R, Lamb J: A study of patient clues and physician responses in primary care and surgical settings. JAMA 2000;284:1021-1027.
10. Davenport S, Goldberg D, Millar T: How psychiatric disorders are missed during medical consultations. Lancet 1987;2: 439-441.
11. Pollak KI, Arnold RM, Jeffreys AS, et al.: Oncologist communication about emotion during visits with patients with advanced cancer. J Clinical Oncol 2007;25:5748-5752.
12. Anderson WG, Alexander SC, Rodriguez KL, Alexander SC, Olsen MK, Abernethy AP, Sugg Skinner C, Rodriguez KL, Tulsky JA: "What concerns me is . . ." Expression of emotion by advanced cancer patients during outpatient visits. Suppor Care Cancer 2008;16:803-811.
13. Detmar SB, Muller MJ, Wever LD, Schornagel JH, Aaronson NK: The patient-physician relationship. Patient-physician communication during outpatient palliative treatment visits: An observational study. JAMA 2001;285:1351-1357.
14. Buss MK, Alexander GC, Switzer GE, Arnold RM: Assessing competence of residents to discuss end-of-life issues. J Palliat Med 2005;8:363-371.
15. Calam B, Far S, Andrew R: Discussions of "code status" on a family practice teaching ward: What barriers do family physicians face? CMAJ 2000;163:1255-1259.
16. Teno JM, Clarridge BR, Casey V, Welch LC, Wetle T, Shield R, Mor V: Family perspectives on end-of-life care at the last place of care. JAMA 2004;291:88-93.
17. Smith AK, Ries AP, Zhang B, Tulsky JA, Prigerson HG, Block SD: Resident approaches to advance care planning on the day of hospital admission. Arch Intern Med 2006;166: 1597-1602.
18. Sullivan AM, Lakoma MD, Block SD: The status of medical education in end-of-life care: a national report. J Gen Intern Med 2003;18:685-695.
19. Fallowfield L, Lipkin M, Hall A: Teaching senior oncologists communication skills: Results from phase I of a comprehensive longitudinal program in the United Kingdom. J Clin Oncol 1998;16:1961-1968.
20. Back AL, Arnold RM, Baile WF, Fryer-Edwards KA, Alexander SC, Barley GE, Gooley TA, Tulsky JA: Efficacy of communication skills training for giving bad news and discussing transitions to palliative care. Arch Intern Med 2007;167:453-460.
21. Sullivan AM, Lakoma MD, Billings JA, Peters AS, Block SD, Faculty PC: Teaching and learning end-of-life care: Evaluation of a faculty development program in palliative care. Acad Med 2005;80:657-668.
22. Sullivan AM, Lakoma MD, Billings JA, Peters AS, Block SD, Faculty PC: Creating enduring change: Demonstrating the long-term impact of a faculty development program in palliative care. J Gen Intern Med 2006;21:907-914.
23. Alexander SC, Keitz SA, Sloane R, Tulsky JA:Acontrolled trial of a short course to improve residents' communication with patients at the end of life. Acad Med 2006;81:1008-1012.
24. Roter DL, Larson S, Fischer GS, Arnold RM, Tulsky JA: Experts practice what they preach: A descriptive study of best and normative practices in end-of-life discussions. Arch Intern Med 2000;160:3477-3485.
25. Kaplan SH, Greenfield S, Gandek B, Rogers WH, Ware JE, Jr: Characteristics of physicians with participatory decisionmaking styles. Ann Intern Med 1996;124:497-504.
26. Roter DL, Stewart M, Putnam SM, Lipkin M, Jr, Stiles W, Inui TS: Communication patterns of primary care physicians. JAMA 1997;277:350-356.
27. Roter DL, Hall JA, Aoki Y: Physician gender effects in medical communication: Ameta-analytic review. JAMA 2002;288: 756-764.
28. Bylund CL, Makoul G: Empathic communication and gender in the physician-patient encounter. Patient Educ Couns 2002;48:207-216.
29. Fallowfield L, Jenkins V, Farewell V, Saul J, Duffy A, Eves R: Efficacy of a Cancer Research UK communication skills training model for oncologists: A randomised controlled trial. Lancet 2002;359:650-656.
30. Roter DL, Hall JA, Kern DE, Barker LR, Cole KA, Roca RP: Improving physicians' interviewing skills and reducing patients' emotional distress. A randomized clinical trial. Arch Intern Med 1995;155:1877-1884.
31. Bonvicini KA, Perlin MJ, Bylund CL, Carroll G, Rouse RA, Goldstein MG: Impact of communication training on physician expression of empathy in patient encounters. Patient Educ Couns 2009;75:3-10.
32. Razavi D, Delvaux N, Marchal S, Durieux JF, Farvacques C, Dubus L, Hogenraad R: Does training increase the use of more emotionally laden words by nurses when talking with cancer patients? A randomised study. Br J Cancer 2002;87:1-7.
33. Wilkinson S, Perry R, Blanchard K, Linsell L: Effectiveness of a three-day communication skills course in changing nurses' communication skills with cancer=palliative care patients: A randomised controlled trial. Palliat Med 2008;22:365-375.
34. Marteau TM, Humphrey C, Matoon G, Kidd J, Lloyd M, Horder J: Factors influencing the communication skills of firstyear clinical medical students. Med Educ 1991;25:127-134.
35. West CP, Huntington JL, Huschka MM, Novotny PJ, Sloan JA, Kolars JC, Habermann TM, Shanafelt TD: A prospective study of the relationship between medical knowledge and professionalism among internal medicine residents. Acad Med 2007;82:587-592.
36. Moore GT, Block SD, Style CB, Mitchell R: The influence of the New Pathway curriculum on Harvard medical students. Acad Med 1994;69:983-989.
37. Easter DW, Beach W: Competent patient care is dependent upon attending to empathic opportunities presented during interview sessions. Curr Surg 2004;61:313-318.
38. Beach WA, Easter DW, Good JS, Pigeron E: Disclosing and responding to cancer "fears" during oncology interviews. Soc Sci Med 2005;60:893-910.
39. Hojat M, Mangione S, Nasca TJ, Rattner S, Erdmann JB, Gonnella JS, Magee M: An empirical study of decline in empathy in medical school. Med Educ 2004;38:934-941.
40. DiMatteo MR, Hays RD, Prince LM: Relationship of physicians' nonverbal communication skill to patient satisfaction, appointment noncompliance, and physician workload. Health Psychol 1986;5:581-594.
41. Matthews DA, Feinstein AR: A new instrument for patients' ratings of physician performance in the hospital setting. J Gen Intern Med 1989;4:14-22.
42. ACGME.org Chicago: The Accreditation Council for Graduate Medical Education: ACGME Outcomes Project 2007; 2005 (cited Sept. 2, 2009). Available from http:==www. acgme.org=outcome=comp=compMin.asp.
43. Hanson LC, Danis M, Garrett J: What is wrong with end-oflife care? Opinions of bereaved family members. J Am Geriatr Soc 1997;45:1339-1344.
44. Steinhauser KE, Christakis NA, Clipp EC, McNeilly M, McIntyre L, Tulsky JA: Factors considered important at the end of life by patients, family, physicians, and other care providers. JAMA 2000;284:2476-2482.
45. Steinhauser KE, Christakis NA, Clipp EC, McNeilly M, Grambow S, Parker J, Tulsky JA: Preparing for the end of life: P of patients, families, physicians, and other care providers. J Pain Symptom Manage 2001;22:727-737.
46. Marvel MK, Epstein RM, Flowers K, Beckman HB: Soliciting the patient's agenda: have we improved? JAMA 1999;281: 283-287.
47. Morita T, Akechi T, Ikenaga M, Kohara H, Mukaiyama T, Nakaho T, Nakashima N, Shima Y, Matsubara T, Fujimori M, Uchitomi Y: Communication about the ending of anticancer treatment and transition to palliative care. Ann Oncol 2004;15:1551-1557.
48. Tulsky JA, Fischer GS, Rose MR, Arnold RM: Opening the black box: How do physicians communicate about advance directives? Ann Intern Med 1998;129:441-449.
49. Butow PN, Brown RF, Cogar S, Tattersall MH, Dunn SM: Oncologists' reactions to cancer patients' verbal cues. Psychooncology 2002;11:47-58.
50. Suchman AL, Markakis K, Beckman HB, Frankel R: A model of empathic communication in the medical interview. JAMA 1997;277:678-682.
51. Levinson W, Gorawara-Bhat R, Lamb J: A study of patient clues and physician responses in primary care and surgical settings. JAMA 2000;284:1021-1027.
52. Davenport S, Goldberg D, Millar T: How psychiatric disorders are missed during medical consultations. Lancet 1987;2: 439-441.
53. Pollak KI, Arnold RM, Jeffreys AS, et al.: Oncologist communication about emotion during visits with patients with advanced cancer. J Clinical Oncol 2007;25:5748-5752.
54. Anderson WG, Alexander SC, Rodriguez KL, Alexander SC, Olsen MK, Abernethy AP, Sugg Skinner C, Rodriguez KL, Tulsky JA: "What concerns me is . . ." Expression of emotion by advanced cancer patients during outpatient visits. Suppor Care Cancer 2008;16:803-811.
55. Detmar SB, Muller MJ, Wever LD, Schornagel JH, Aaronson NK: The patient-physician relationship. Patient-physician communication during outpatient palliative treatment visits: An observational study. JAMA 2001;285:1351-1357.
56. Buss MK, Alexander GC, Switzer GE, Arnold RM: Assessing competence of residents to discuss end-of-life issues. J Palliat Med 2005;8:363-371.
57. Calam B, Far S, Andrew R: Discussions of "code status" on a family practice teaching ward: What barriers do family physicians face? CMAJ 2000;163:1255-1259.
58. Teno JM, Clarridge BR, Casey V, Welch LC, Wetle T, Shield R, Mor V: Family perspectives on end-of-life care at the last place of care. JAMA 2004;291:88-93.
59. Smith AK, Ries AP, Zhang B, Tulsky JA, Prigerson HG, Block SD: Resident approaches to advance care planning on the day of hospital admission. Arch Intern Med 2006;166: 1597-1602.
60. Sullivan AM, Lakoma MD, Block SD: The status of medical education in end-of-life care: a national report. J Gen Intern Med 2003;18:685-695.
61. Fallowfield L, Lipkin M, Hall A: Teaching senior oncologists communication skills: Results from phase I of a comprehensive longitudinal program in the United Kingdom. J Clin Oncol 1998;16:1961-1968.
62. Back AL, Arnold RM, Baile WF, Fryer-Edwards KA, Alexander SC, Barley GE, Gooley TA, Tulsky JA: Efficacy of communication skills training for giving bad news and discussing transitions to palliative care. Arch Intern Med 2007;167:453-460.
63. Sullivan AM, Lakoma MD, Billings JA, Peters AS, Block SD, Faculty PC: Teaching and learning end-of-life care: Evaluation of a faculty development program in palliative care. Acad Med 2005;80:657-668.
64. Sullivan AM, Lakoma MD, Billings JA, Peters AS, Block SD, Faculty PC: Creating enduring change: Demonstrating the long-term impact of a faculty development program in palliative care. J Gen Intern Med 2006;21:907-914.
65. Alexander SC, Keitz SA, Sloane R, Tulsky JA:Acontrolled trial of a short course to improve residents' communication with patients at the end of life. Acad Med 2006;81:1008-1012.
66. Roter DL, Larson S, Fischer GS, Arnold RM, Tulsky JA: Experts practice what they preach: A descriptive study of best and normative practices in end-of-life discussions. Arch Intern Med 2000;160:3477-3485.
67. Kaplan SH, Greenfield S, Gandek B, Rogers WH, Ware JE, Jr: Characteristics of physicians with participatory decisionmaking styles. Ann Intern Med 1996;124:497-504.
68. Roter DL, Stewart M, Putnam SM, Lipkin M, Jr, Stiles W, Inui TS: Communication patterns of primary care physicians. JAMA 1997;277:350-356.
69. Roter DL, Hall JA, Aoki Y: Physician gender effects in medical communication: Ameta-analytic review. JAMA 2002;288: 756-764.
70. Bylund CL, Makoul G: Empathic communication and gender in the physician-patient encounter. Patient Educ Couns 2002;48:207-216.
71. Fallowfield L, Jenkins V, Farewell V, Saul J, Duffy A, Eves R: Efficacy of a Cancer Research UK communication skills training model for oncologists: A randomised controlled trial. Lancet 2002;359:650-656.
72. Roter DL, Hall JA, Kern DE, Barker LR, Cole KA, Roca RP: Improving physicians' interviewing skills and reducing patients' emotional distress. A randomized clinical trial. Arch Intern Med 1995;155:1877-1884.
73. Bonvicini KA, Perlin MJ, Bylund CL, Carroll G, Rouse RA, Goldstein MG: Impact of communication training on physician expression of empathy in patient encounters. Patient Educ Couns 2009;75:3-10.
74. Razavi D, Delvaux N, Marchal S, Durieux JF, Farvacques C, Dubus L, Hogenraad R: Does training increase the use of more emotionally laden words by nurses when talking with cancer patients? A randomised study. Br J Cancer 2002;87:1-7.
75. Wilkinson S, Perry R, Blanchard K, Linsell L: Effectiveness of a three-day communication skills course in changing nurses' communication skills with cancer=palliative care patients: A randomised controlled trial. Palliat Med 2008;22:365-375.
76. Marteau TM, Humphrey C, Matoon G, Kidd J, Lloyd M, Horder J: Factors influencing the communication skills of firstyear clinical medical students. Med Educ 1991;25:127-134.
77. West CP, Huntington JL, Huschka MM, Novotny PJ, Sloan JA, Kolars JC, Habermann TM, Shanafelt TD: A prospective study of the relationship between medical knowledge and professionalism among internal medicine residents. Acad Med 2007;82:587-592.
78. Moore GT, Block SD, Style CB, Mitchell R: The influence of the New Pathway curriculum on Harvard medical students. Acad Med 1994;69:983-989.
79. Easter DW, Beach W: Competent patient care is dependent upon attending to empathic opportunities presented during interview sessions. Curr Surg 2004;61:313-318.
80. Beach WA, Easter DW, Good JS, Pigeron E: Disclosing and responding to cancer "fears" during oncology interviews. Soc Sci Med 2005;60:893-910.
81. Hojat M, Mangione S, Nasca TJ, Rattner S, Erdmann JB, Gonnella JS, Magee M: An empirical study of decline in empathy in medical school. Med Educ 2004;38:934-941.
82. DiMatteo MR, Hays RD, Prince LM: Relationship of physicians' nonverbal communication skill to patient satisfaction, appointment noncompliance, and physician workload. Health Psychol 1986;5:581-594.
83. Matthews DA, Feinstein AR: A new instrument for patients' ratings of physician performance in the hospital setting. J Gen Intern Med 1989;4:14-22.
84. ACGME.org Chicago: The Accreditation Council for Graduate Medical Education: ACGME Outcomes Project 2007; 2005 (cited Sept. 2, 2009). Available from http:==www. acgme.org=outcome=comp=compMin.asp.