Communication skills workshop curriculum: overview presentation and skills practice
| Session | Overview Presentation | Skills Practice with Simulated Patient and Family Member | Fellow Goals for Skills Practice |
|---|---|---|---|
| Giving bad news | Skills taught: Giving information: Ask-Tell-Ask (see Box 2) Recognizing and responding to emotion:NURSE acronym (see Box 2) | Background: 65-year-old man with diabetes and hypertension recently hospitalized for an elective coronary artery bypass with worsening renal function Practice setting: Fellow meeting with patient in clinic to discuss worsening renal function | Use Ask-Tell-Ask to discuss worsening kidney function and potential dialysis preparation Attend to patient’s emotion from hearing the news using NURSE acronym |
| Defining goals of care | Skills taught: Use open-ended questions to elicit care goals and end-of-life preferences Respond to unrealistic goals with “wish” statements | Background: 1 year has passed; patient is hospitalized with a large myocardial infarction and is in cardiogenic shock and life support with serum creatinine level of 5.5 mg/dl Practice setting: Fellow meeting with patient’s health care power of attorney in the intensive care waiting room to discuss goals of care | Elicit patient’s “big picture” goals and preferences in context of intensive care, such as dialysis Respond to wishes for a miracle using a “wish” statement Propose a plan that fits the patient’s goals and preferences |