Program Helps Kidney Specialists Discuss Difficult News with Patients

Article ID: 595529

Released: 2-Nov-2012 9:00 AM EDT

Source Newsroom: American Society of Nephrology (ASN)

Participants give program great reviews

Highlights• Kidney specialists do not routinely receive formal education on how to talk with patients about end-of-life and other serious issues.• A new workshop helps nephrology fellows be prepared to deliver bad news, express empathy, and discuss dialysis initiation and withdrawal.

Newswise — Washington, DC (November 8, 2012) — Kidney specialists, or nephrologists, care for a medically complex population and frequently must discuss serious news with patients: giving a diagnosis of kidney disease, explaining the risks and benefits of treatments, and defining care goals at the end of life. Yet nephrologists do not routinely receive formal education on how to engage in these types of conversations. A new communication skills workshop for nephrology fellows could change that, according to a study appearing in an upcoming issue of the Clinical Journal of the American Society of Nephrology (CJASN).

To address the need for structured communication training in nephrology programs, Jane Schell, MD (University of Pittsburgh) and her colleagues designed a formal workshop, called NephroTalk, aimed at providing nephrology fellows with communication skills in discussing dialysis decision-making and end-of-life care. The workshop, modeled after a national oncology workshop called OncoTalk, is comprised of educational sessions on delivering bad news and defining goals of care when a patient is not doing well. It involves small group sessions with standardized patients. The skills that are taught and practiced include assessing patient understanding before giving news, recognizing and responding to patients’ emotional concerns, and eliciting patients’ goals and end-of-life preferences.

The workshop was offered to 22 nephrology fellows at Duke University and the University of Pittsburgh. Surveys conducted before and dafter the workshop revealed the following:

• The average level of perceived preparedness significantly increased for all skills, including delivering bad news, expressing empathy, and discussing dialysis initiation and withdrawal. • All respondents reported that they would recommend this training to other fellows.• 95% said the workshop should be required of all nephrology fellows.

“Communication is central to what we do as physicians. Our goal is for NephroTalk to serve as a model curriculum for enhancing communication education within nephrology training,” said Dr. Schell.

Study co-authors include Jamie Green, MD (Geisinger Health System), Robert Arnold, MD (University of Pittsburgh); and James Tulsky, MD (Duke University)

Disclosures: The authors reported no financial disclosures.

The article, entitled “Communication Skills Training for Dialysis Decision-Making and End of Life Care in Nephrology,” will appear online at http://cjasn.asnjournals.org/ on November 8, 2012, doi: 10.2215/05220512.

The content of this article does not reflect the views or opinions of The American Society of Nephrology (ASN). Responsibility for the information and views expressed therein lies entirely with the author(s). ASN does not offer medical advice. All content in ASN publications is for informational purposes only, and is not intended to cover all possible uses, directions, precautions, drug interactions, or adverse effects. This content should not be used during a medical emergency or for the diagnosis or treatment of any medical condition. Please consult your doctor or other qualified health care provider if you have any questions about a medical condition, or before taking any drug, changing your diet or commencing or discontinuing any course of treatment. Do not ignore or delay obtaining professional medical advice because of information accessed through ASN. Call 911 or your doctor for all medical emergencies.

Founded in 1966, and with more than 13,500 members, the American Society of Nephrology (ASN) leads the fight against kidney disease by educating health professionals, sharing new knowledge, advancing research, and advocating the highest quality care for patients.

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