Improving Patient-Health Care Provider End-of-Life Communication Using Improvisational Theater Techniques: Outcome of a Workshop

Abstract

Background Communication plays a significant role in health care. While evidence showed the strong relationship between good communication and better patient outcomes including emotional health, symptom resolution, function, physiologic measures, pain control and adherence, miscommunication can results in medical errors, extra financial cost and negative attitude of health care providers. Health communication can be particular challenging in palliative care given the fact that palliative care is often link to poor prognosis, end of life and increased emotionally laden. Although more and more studies and programs were developed to teach health care providers communication skills, few of them provided interdisciplinary education despite the increasing emphasis of teamwork in health care. This project focuses on improving health care providers’ communication ability by using an innovative teaching method and emphasizing on teamwork through a 2-phase workshop. Method In the first phase, medical teams that have a goal to improve palliative and end of life care were recruited to a two part immersion workshop. Teams consisted of nurses, physicians and a chaplain, social worker or equivalent. During phase one of the workshop, these teams were exposed to a nationally-recognized lecturer and engaged in learning medical improv techniques. After 6 months, the teams were invited to complete a 2 day long update workshop including additional training using Vital Talk techniques and principles from Team STEPPs. Outcomes such as communication behavior, confidence and workshop evaluation were measured pre and post workshop. Results 14 participants included nurses, physicians, social workers and patient navigators completed the 2-phase workshop and outcome evaluation. The results showed that participants’ communication skills and confidence both improved. The self-identified weakest behavior and confidence improved the most compared to other types of behavior and confidence. In addition, this improvement is cross professions. In general, participants thought that the workshop was very valuable. Conclusion Both the workshop content and instructors received extremely positive feedback regarding interactive presentation, involvement, quality of scientific content and content appropriateness for target audience. This innovative workshop offered a promising way to teach health care providers how to communicate with terminal patients and enhance their confidence. More studies are needed to evaluate long-term and clinical outcomes.