033 - Can communication skills be taught in a multidisciplinary maternal fetal care center?

Publication Number: 33.4205

Lauren Crafts, Boston Children's Hospital, Brookline, MA, United States; Kassie Merrill-Olver, Boston Children's Hospital, Boston, MA, United States; Alireza Shamshirsaz, Boston Children’s Hospital, Boston, MA, United States; Christina Ronai, Boston Children's Hospital, Boston, MA, United States

Background: Effective communication is an important skill for providers performing prenatal counseling. Clinicians must lead conversations disclosing a new diagnosis, describing perinatal management plan, discussing short- and long-term prognoses, and acknowledging uncertainty. Communication skills training has been shown to improve clinicians’ communication skills, ability to deliver bad news, respond to patient emotional cues, check patient understanding, and meet informational and emotional needs of patients. Despite the importance of strong communication skills and the effectiveness of communication training, few studies have evaluated a structured communication training for providers performing prenatal counseling.

Objective: To determine if a communication intervention using a standardized methodology improves fetal care center staff preparedness and comfort with communicating serious news.

Design/Methods: Fetal providers participated in two, half-day, virtual communication training sessions using VitalTalk methodology, led by VitalTalk facilitators. Each session, providers learned the methodology for 45 minutes and then participated in role play with standardized actors. Anonymous, electronic, pre- and post-surveys were administered to participants via REDCap. Participants were asked about their preparedness and comfort performing certain communication skills and leading challenging conversations specific to prenatal counseling. Response options used a combination of 0 (low comfort/preparedness) to 100 (high comfort/preparedness) point scales and multiple choice.

Results: 24 providers participated in the training (12 physicians, 4 nurses, 2 advanced practice practitioners, 3 clinical social workers, 2 genetic counselors, and 1 chaplain). Clinical and prognostic uncertainty and balancing honesty with hope were the top factors that contributed to making conversations difficult. Following the course, there was a statistically significant increase in preparedness and comfort to perform all queried counseling skills (Table 1). Most providers felt a refresher course yearly or every 2-3 years would be helpful.

Conclusion(s): Communicating serious news effectively is a skill that can be learned and is especially important in the field of fetal counseling. Our study demonstrates that an interactive, VitalTalk course can improve preparedness and comfort to deliver serious news in a cohort of multidisciplinary fetal care center providers. Future studies are needed to evaluate translation of skills to clinical practice and durability of these skills in larger cohorts.

Change in Median Preparedness and Comfort Following Session
PAS Table for Submission.pdf*Prepared scale from 0 (very unprepared) to 100 (very prepared)
^Comfort scale from 0 (very uncomfortable) to 100 (very comfortable)