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Educational interventions for training in end-of-life communication may increase self-efficacy, knowledge and communication skills in healthcare professionals

Chung HO, Oczkowski SJ, Hanvey L, et al.  Educational interventions to train healthcare professionals in end-of-life communication: A systematic review and meta-analysis  BMC Medical Education. 2016 April;16:131.

Review question

Do educational interventions for end-of-life communication skills improve self-efficacy, knowledge and communication proficiency amongst healthcare professionals for end-of-life communication and decision-making?

Background

Healthcare providers often fail to truly consider and engage patient wishes in end-of-life discussions and decisions. This increases the risk of patients receiving futile or unnecessarily aggressive medical care, which may reduce quality of life for both patients and professionals.

Despite the recognized importance of end-of-life communication and the training programs available, medical graduates are poorly prepared to discuss these issues with patients, and the evidence of effectiveness remains unclear.

It is important to evaluate these end-of-life communication training programs, which are a promising means of increasing communication skills and related outcomes amongst healthcare professionals.

How the review was done

A detailed search of a number of electronic databases for all years up to and including July 2014 was conducted, and studies that focused on communication tools that assisted adult patients in end-of-life decisions were included.

A total of 166 studies were identified in searches and 20 were included in the review after assessments for eligibility.

This review was funded by the Technology Evaluation in the Elderly Network.

What the researchers found

This review found that end-of-life communication skills training may improve healthcare provider self-efficacy and knowledge when dealing with end-of-life communication and decision-making.

Training may also improve communication skills, such as improved sharing of knowledge between healthcare professional and patient, and allowing for clearer explanations, as assessed by interactions with standardized patients.

The results concerning important outcomes for patients, such as satisfaction, were limited and mixed to meaningfully reported. Overall, these results are based on low to very low-quality evidence, and should be interpreted with caution.

Conclusion

This review found that the training in end-of-life communication for healthcare professionals may improve self-efficacy, communication skills and knowledge when compared to no formal training. However, more evidence is required to consolidate these findings and to assess the impact of end-of-life communication training on outcomes important to the patient.