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That was a game changer: clinical impact of an emergency department-based palliative care communication skills training workshop
  1. Rebecca Wright1,
  2. Bradley Hayward2,
  3. Emmett Kistler3,
  4. Victoria Vaughan Dickson4,
  5. Corita Grudzen5
  1. 1Johns Hopkins University School of Nursing, Baltimore, Maryland, USA
  2. 2Joan and Sanford I Weill Medical College of Cornell University, New York, New York, USA
  3. 3Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
  4. 4New York University College of Nursing, New York, New York, USA
  5. 5Emergency Medicine, New York University School of Medicine, New York, New York, USA
  1. Correspondence to Dr. Rebecca Wright; rebeccapollyblackwell{at}


Objective To explore the impact of an adapted goals-of-care communications skills workshop created for ED physicians from the physicians’ perspective.

Methods Semi-structured, one-on-one audio-recorded interviews lasting 30–60 min were conducted with twelve physicians who had completed the training workshop. Interviews explored the experience of undertaking the workshop, its impact on their clinical practice and their ability to teach new skills to other clinicians using learnt techniques. Descriptive content analysis was performed on interview transcripts.

Results Participants reported positive experiences of the workshop. The analysis identified four main themes and ten subthemes dealing with workshop content and its impact on subsequent ED-based clinical practice. There were: 1) value and future improvements for the course; 2) value of the course to practice; 3) value of the course for teaching residents and 4) barriers to application of learning. Specifically recommended components include the use of mnemonics, mechanisms to introduce difficult conversations and a positive feedback environment. Participant-recommended refinements to the workshop included emphasising urgency, replicating the chaotic ED environment and expanding content to include more ED-focused goals-of-care discussions.

Conclusion A short, focused training workshop directed at improving palliative care communication skills among ED clinicians appears to be welcomed and useful.

  • education
  • communications
  • education, methods
  • emergency department
  • qualitative research

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  • Contributors RW co-conducted the interviews, analysis and is the main author for this article. BH co-conducted the interviews, analysis and contributed to writing and editing of this article. EK contributed to the analysis of the data and editing of this article. VVD created the interview topic guide and contributed to the editing of this article. CG was the Principle Investigator of this study, developing the study, supporting the analysis of the data and overseeing the writing and editing of this article.

  • Funding The educational intervention was funded by grant monies from the Fridolin Charitable Trust. The research reporting on the intervention was funded by a grant from Cambia Health Foundation.

  • Competing interests Grant money for investigator initiated research. CG reports grant money from the Fridolin Charitable Trust, which funded the educational intervention evaluated by the research reported in this manuscript. The evaluation research was funded by a grant from Cambia Health Foundation.

  • Ethics approval Ethical approval granted by the New York University School of Medicine Institutional Review Board: NYU IRB number i15-00873.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Presented at 9–11 March 2016 AAHPM and HPNA Annual Assembly, Sojourns Scholar Cambia Health Foundation: poster presentation, Chicago.

  • Patient consent for publication Not required.

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