Pilot and Evaluation of the initial version of the Real Talk training resources

Training can enhance practice in palliative care communication. However, there is scope to improve training so as to increase its effectiveness. The Real Talk project is part of a wider research project called VERDIS (Video-based communication research and training in supportive and palliative care), funded by the Health Foundation and the NIHR. Real Talk resources are designed to provide video-based and written materials to communication trainers which help them enhance training’s authenticity and evidence-base.

Creating Real Talk – what we did:

• Recorded 37 consultations at an English hospice, with 37 patients, 17 relatives and friends and 5 experienced doctors in inpatient, outpatient, and day therapy clinics
• Applied the Conversation Analytic approach to analyse these consultations, examining how experienced doctors communicated with patients about end of life issues
• Consulted widely to establish what a communication skills training resource should and could contain
• Used our analysis to create a range of cases made up of short video clips and supporting materials
• Developed these cases to create the ‘Real Talk Training Resource’ and obtained ethical approval to pilot Real Talk in a range of organisations

What is Real Talk?

The initial version of Real Talk contains six patient cases. Each case contains one or more video clips, we organised the cases in terms of two key modules on these themes:

• Broaching Dying
• Responding to ‘How Long have I got?’ enquiries

Each case is supported by a case synopsis, a transcript of each clip, learning points for facilitators to use and suggestions for further reading.

Recruiting Trainers

In 2015 we aimed to evaluate the usability and acceptability of the initial Real Talk resources across a range of training events and practitioner groups. The resources are designed to be used in existing communication skills training programmes.

Experienced advanced communication skills trainers were recruited from across England. The resources were provided to the 44 trainers who expressed an interest in taking part in the pilot.

A researcher systematically observed 10 different training events, conducted 11 telephone interviews with trainers and collected 150 questionnaires completed by workshop trainees.  The pilot represented 6 Hospices, 5 HEI’s and 2 NHS organisations.

Findings: Key messages from the trainers’ perspective:

“I think it’s streets ahead, to be honest. Absolutely streets ahead, the reason being is that it is, as the title says, it’s so real. It’s humbling. Every time you watch it, it affects you differently…”

“It always surprises me in communication skills training, that sort of, trust your audience mantra… I always find that a little bit unnerving. But it worked really well, they were superb…”

“It’s very bitesize… it’s very powerful and that’s amazing really…”

Findings: Key messages from the trainees’ perspective:

“Discussing the recording together really helped to acknowledge and talk through the emotions it evoked…”

“The topic was unavoidably difficult. I found the recordings helpful to get in touch with these experiences and prompt reflection in working practice …”

“It’s emotionally upsetting but did not impact on my learning, mainly because it highlights what you do as health care professionals working in palliative care…”

Conclusion

The five-month pilot allowed us to examine the usability of the resource. Overall it was overwhelmingly welcomed by both trainers and trainees as an effective and safe tool to use in communication skills training, adding depth and value to the learning experience. Trainees reported that they particularly valued: the realness, the importance of skilled facilitation, group discussions, exploring and responding to emotions and concerns, and consolidating the learning experience. Real Talk aims to capitalise on these insights and demonstrate how they can underpin future practice.

Information

2018 Palliative Care conference poster presentation reporting on the Evaluation Project outcomes https://spcare.bmj.com/content/8/Suppl_1/A8.2

For more information go to our website www.realtalktraining.co.uk or follow us on twitter @RealTalk_EOLC

Acknowledgements to: 

Loughborough University, University of Nottingham, LOROS Hospice Leicester, The Health Foundation and the NIHR. The views expressed in this publication are those of the authors and not necessarily those of the NHS, the National Institute for Health Research, Health Education England or the Department of Health and Social Care.