NephroTalk: Evaluation of a Palliative Care Communication Curriculum for Nephrology Fellows

Context. Nephrologists care for a medically complex population that faces difficult decisions around treatment options and end-of-life care. Yet communication training within nephrology fellowship is rare. Prior work suggests that communication training in nephrology can improve perceived preparedness to engage in difficult conversations; however, it is unclear if this training results in improved clinical skills. Objectives. The primary aim was to evaluate the efficacy of a three-day curriculum for nephrology fellows (NephroTalk) to improve communication skill acquisition for delivering serious news. We also measured self-reported preparedness for three additional communication tasks taught, including goals of care and transitions at end of life. Methods. Thirty-three first-and second-year fellows from seven academic nephrology programs participated in NephroTalk from 2015 to 2016. Pretraining and post-training encounters to deliver bad news with standardized patients were audiorecorded and evaluated using a modified communication checklist. Fellow experience and self-reported improvement in communication tasks were measured using a five-point Likert scale. Results. Skill use increased after training for seven of the nine skills measured (P < 0.01). The average number of skills gained after training was 3.6 +/- 1.8 skills. With increased communication proficiency, post-training encounters were significantly shorter than pretraining encounters (P = 0.03). Fellows reported improved preparedness to engage in all communication tasks taught in NephroTalk curriculum. Conclusion. Our findings support NephroTalk as an effective communication skills curriculum for nephrology trainees. Fellows increased their communication skills significantly in delivering bad news leading to more efficient encounters. (C) 2018 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.