Virtual Communication Training for Telemedicine

Overseen By Rache l M Lacy, MPH

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Virginia

Disqualifiers: Under 18, Inability to consent

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 2

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to improve how OB/GYN residents communicate difficult news to patients and their families, especially when done remotely, such as over the phone. The goal is to teach these doctors to handle sensitive conversations, like end-of-life discussions, through virtual training on breaking bad news remotely. This is important because COVID-19 has changed doctor-patient interactions, leading to more telehealth visits and fewer in-person meetings. The trial seeks residents in the University of Virginia's OB/GYN program who can consent to participate. As an unphased trial, this study offers residents a unique opportunity to enhance their communication skills, benefiting both their professional development and patient care.

Do I need to stop my current medications for this trial?

The trial protocol does not specify whether you need to stop taking your current medications.

What prior data suggests that this virtual communication training is safe for residents?

Research has shown that virtual communication training safely and effectively teaches healthcare professionals how to deliver bad news. Studies indicate that using virtual patients or simulations yields better results than no training. In one study, students found simulation training helpful for learning how to have difficult conversations. Another study compared in-person and online training methods and found that virtual platforms did not negatively affect student performance.

These findings suggest that participants generally find the training useful and beneficial, and it does not cause harm. This is encouraging for anyone considering joining a trial for virtual communication training in healthcare settings. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about this virtual communication training because it focuses on enhancing the skills needed to break bad news to family members remotely, a growing necessity in the era of telemedicine. Unlike traditional in-person communication training, this program is specifically tailored for virtual interactions, addressing the unique challenges of conveying empathy and clarity through a screen. Additionally, the training is designed for residents, equipping them with essential skills early in their careers, which is crucial as telemedicine becomes more prevalent in healthcare. By targeting these specific needs, the training aims to improve patient and family experiences, even when care is delivered remotely.

What evidence suggests that this virtual communication training is effective for improving telemedicine skills?

Research has shown that using virtual patients to teach healthcare professionals how to deliver bad news is effective. In this trial, all residents will engage in virtual communication training focused on remotely breaking bad news to family members. Studies have found that virtual communication training yields better results than no training. In one study, nurse practitioner students felt more prepared to give bad news after practicing with simulations. Another study demonstrated that learners improved their skills in delivering bad news using virtual tools. While in-person simulations have been common, virtual training has gained importance, especially with the rise of telehealth visits. Overall, virtual patient simulations are recognized for enhancing communication skills in difficult conversations. ^{1 2 5 6 7}

Are You a Good Fit for This Trial?

This trial is for OB/GYN residents at the University of Virginia who can give informed consent. It's not open to those under 18 or anyone unable to agree to participate understandingly.

Inclusion Criteria

residents in University of Virginia's residency in Obstetrics and Gynecology

able to provide informed consent

Exclusion Criteria

I am unable to understand and agree to the study's details.

I am under 18 years old.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Didactic Sessions

Residents participate in virtual didactic sessions reviewing strategies for breaking bad news, including lectures and discussions.

2 months

2 sessions (virtual)

Role-Playing and Feedback

Residents engage in role-playing scenarios with faculty feedback to practice breaking bad news in different medical contexts.

1 month

Multiple sessions (virtual)

Follow-up

Residents are assessed on changes in comfort with end-of-life conversations 3 months after the intervention.

3 months

What Are the Treatments Tested in This Trial?

Interventions

• Education on breaking bad news to family members remotely

Trial Overview

The study tests a virtual training program teaching OB/GYN residents how to deliver bad news and handle end-of-life conversations by phone or telehealth, due to pandemic restrictions.

How Is the Trial Designed?

Group I: Residents Experimental Treatment 1 Intervention

All residents will participate in the activity

Who Is Running the Clinical Trial?

University of Virginia

Lead Sponsor

Trials

802

Recruited

1,342,000+

Published Research Related to This Trial

Patients expect timely and full disclosure of adverse events in medical care, which can strengthen the patient-physician relationship and reduce the likelihood of litigation if handled transparently.

Barriers to disclosure include fear of retribution and a culture of blame; therefore, establishing a nonpunitive environment in healthcare settings is crucial for encouraging reporting and improving patient safety.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Committee Opinion No. 681 Summary: Disclosure and Discussion of Adverse Events. [2021]

A study involving 41 healthcare professionals assessed satisfaction with two formats of a course on breaking bad news over the phone, revealing that both fully streamed and blended formats were well-received, with a slight preference for the fully streamed format due to better interaction activities.

The findings highlight the importance of such training courses, which are requested by professionals, and emphasize the value of interprofessional education, including administrative staff, to enhance the overall care experience for families.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Teaching (remotely) to communicate (remotely) with relatives of patients during lockdown due to the COVID-19 pandemic. Ayora, A., Nogueras, C., Jiménez-Panés, S., et al.[2023]

Virtual patients are effective tools for teaching healthcare professionals how to break bad news, showing better outcomes compared to no intervention and comparable results to traditional simulated patients.

Despite their benefits, virtual patients have limitations, such as a lack of emotional interaction, indicating that while they are valuable, they should complement rather than replace existing educational methods.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The use of virtual patients for breaking bad news: A rapid review. Kang, W.[2023]

A new training package was developed to help healthcare staff deliver bad news over the phone during the COVID-19 pandemic, consisting of a 15-minute eLearning session and a 1-hour role-play with feedback from a professional actor.

Key strategies for effective communication included ensuring the recipient's safety during the call, allowing for silence after delivering bad news, and providing written notes and the option for a follow-up call to enhance understanding and support.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Time-critical telephone conversations in the emergency department: lessons learnt from a pilot educational project to improve communication skills over the telephone in response to the COVID-19 global pandemic. Edwards, S., Keillor, L., Sandison, L., et al.[2022]

A study involving 33 Ob/Gyn residents revealed that 77% lacked the necessary skills to effectively break bad news to patients, highlighting a significant training gap in this area.

The implementation of a virtual training program based on the ADDIE model resulted in improved cognitive and attitudinal scores among residents, with a satisfaction rate of 96.5%, indicating the program's effectiveness in enhancing communication skills.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Virtual Instructional Design Improved Breaking Bad News in Obstetrics and Gynecology Residents. Rezayof, E., Akhavan, S., Afshar, L., et al.[2023]

Both patients and healthcare professionals agree on the importance of disclosing adverse events, with patients specifically wanting timely communication, apologies when necessary, and reassurances about their ongoing care.

There is a significant gap between the ideal practices of disclosure and what actually occurs, highlighting the need for improved policies that include the roles of all healthcare team members in the disclosure process.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Disclosure of patient safety incidents: a comprehensive review. O'Connor, E., Coates, HM., Yardley, IE., et al.[2018]

A study involving 29 first-year pediatric residents showed significant improvement in their ability to deliver bad news after training with the 'GRIEV_ING Death Notification Protocol', assessed at three different time points.

The improvement in communication skills was sustained over time, highlighting the effectiveness of the educational intervention and the importance of ongoing training in communication for pediatric residents.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Breaking bad news is a teachable skill in pediatric residents: A feasibility study of an educational intervention. Reed, S., Kassis, K., Nagel, R., et al.[2016]

There is a significant lack of research on how to effectively communicate bad news in clinical settings in India, despite the high incidence of serious health issues and socioeconomic disparities.

The article identifies key areas for future research, including how much bad news to share, cultural and ethical considerations, managing psychological distress, and training healthcare professionals to communicate effectively.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A synthesis of the literature on breaking bad news or truth telling: potential for research in India. Martis, L., Westhues, A.[2021]

The COVID-19 pandemic has necessitated remote communication of bad news by healthcare professionals, primarily through telephone calls, which presents unique challenges due to the lack of body language and limited training in such communication skills.

The manuscript provides structured recommendations for effectively delivering bad news remotely, aimed at improving the experience for patients, families, and caregivers while also supporting healthcare professionals in managing the emotional impact of these conversations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Recommendations for communicating bad news by phone during the SARS-CoV-2 pandemicRecomendações para a comunicação de más notícias por telefone durante a pandemia do SARS-CoV-2]. Belli, LF.[2020]

Patients receiving difficult prenatal news by telephone prefer a patient-centered approach that includes empathy and continuity of care, aligning with the SPIKES protocol for delivering such news.

Participants suggested improvements like discussing the mode of result disclosure during pretest counseling and providing personalized resources, indicating a desire for better communication and support during these challenging conversations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Prenatal patient perceptions of receiving difficult news over the telephone. Douglas, TC., May, C., Dent, K., et al.[2023]

Patients expect full and timely disclosure of adverse events in medical care, which can strengthen trust in the patient-physician relationship and reduce the likelihood of litigation.

Barriers to disclosure include fear of retribution and a culture of blame; therefore, establishing a nonpunitive environment in healthcare settings is crucial for encouraging honest reporting and improving patient safety.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Committee Opinion No. 681: Disclosure and Discussion of Adverse Events. [2021]

A review of 23 studies highlighted that healthcare professionals face challenges in effectively disclosing adverse events, indicating a need for better communication strategies and training.

Implementing specific interpersonal communication skills and fostering an open organizational culture can help healthcare professionals provide more effective and tailored disclosures to patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Disclosing Adverse Events in Clinical Practice: The Delicate Act of Being Open. Myren, BJ., de Hullu, JA., Bastiaans, S., et al.[2022]

Patients and family members desire clear information and sincere regret from healthcare professionals (HCPs) when adverse events occur, while HCPs face barriers such as a blame culture and fear of litigation that hinder effective disclosure.

To improve disclosure practices, training for HCPs and fostering a transparent organizational culture are essential, as both patients and HCPs have different needs and expectations regarding the disclosure of adverse events.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The views and experiences of patients and health-care professionals on the disclosure of adverse events: A systematic review and qualitative meta-ethnographic synthesis. Sattar, R., Johnson, J., Lawton, R.[2023]

Citations

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pubmed.ncbi.nlm.nih.gov

pubmed.ncbi.nlm.nih.gov/37860892/

The use of virtual patients for breaking bad news

This rapid review aimed to review literature observing the potential of virtual patients as an effective means to teach breaking bad news.

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withpower.com

withpower.com/trial/phase-1-2021-a895c

Virtual Communication Training for Telemedicine

Virtual patients are effective tools for teaching healthcare professionals how to break bad news, showing better outcomes compared to no intervention and ...

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sciencedirect.com

sciencedirect.com/science/article/pii/S2772628223000316

Teaching (remotely) to communicate ...

Training in communication and specifically in breaking bad news is a demand from healthcare professionals. •. Interprofessional education fits better the ...

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onlinelibrary.wiley.com

onlinelibrary.wiley.com/doi/10.1111/tct.13387

Video‐mediated breaking bad news simulation - Rivet - 2021

These in-person simulations have been shown to improve learner competency in BBN and are positively received; however, little work has been done ...

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researchgate.net

researchgate.net/publication/363533339_Breaking_Bad_News_via_Telehealth_Simulation_Training_for_Nurse_Practitioner_Students

Simulation Training for Nurse Practitioner Students

Results Students' self-rated levels of preparedness for delivering bad news were higher after participating in the simulation. Students found ...

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mededportal.org

mededportal.org/doi/10.15766/mep_2374-8265.11323

In-Person Versus Remote Standardized Patient Approach

We compared results between the previous in-person and remote SP encounter groups to evaluate the impact on student performance of breaking bad ...

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pubmed.ncbi.nlm.nih.gov

pubmed.ncbi.nlm.nih.gov/36098544/

Breaking Bad News via Telehealth: Simulation Training for ...

Conclusion: Breaking bad news via virtual platforms is new and challenging. Findings suggest this simulation experience provided a valuable tool ...