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| Sponsor: | University of Washington |
|---|---|
| Collaborator: |
National Institute of Nursing Research (NINR) |
| Information provided by: | University of Washington |
| ClinicalTrials.gov Identifier: | NCT00687349 |
Purpose
This research study is a randomized trial to evaluate a training program that is designed to improve the communication skills of clinicians. The training program focuses on care for patients with serious illnesses and their family members, and assesses effectiveness using patient and family outcomes. The long term goal of this research is to improve communication skills of doctors and nurses, thereby improving patient and family outcomes.
| Condition | Intervention | Phase |
|---|---|---|
|
Advanced Cancer Chronic Obstructive Airway Disease Restrictive Lung Disease Congestive Heart Failure End Stage Liver Disease |
Behavioral: Training Program Intervention |
Phase III |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Supportive Care |
| Official Title: | Improving Patient Outcomes in End-of-Life Care Provided by Physicians and Nurses |
| Estimated Enrollment: | 14550 |
| Study Start Date: | April 2007 |
| Estimated Study Completion Date: | March 2012 |
| Estimated Primary Completion Date: | March 2012 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Intervention Arm
The training program will assign resident or NP student to a rotation. They will be receiving the educational intervention during 8 half-day sessions.
|
Behavioral: Training Program Intervention
Resident or NP Student receives the educational intervention during 8 half-day sessions.
|
|
No Intervention: Control Arm
Resident or NP student is assigned to usual education.
|
Three decades of research on end-of-life care in the United States indicates that people who are dying often spend their final days with a significant burden of pain and other symptoms and receive care they would not choose. Patient-clinician communication about end-of-life care is an important focus for improving patient-centered end-of-life care for three reasons: 1) it is an integral component of clinician skill that affects all other aspects of end-of-life care; 2) physicians and nurses in practice do not demonstrate adequate skills for communicating about end-of-life care; and 3) current training in end-of-life communication is inadequate. Studies have shown that clinicians can improve their communication skills with experiential training, but no studies to date have shown that an intervention to improve clinician communication skill improves patient outcomes. Furthermore, despite widespread knowledge that end-of-life care is best delivered in an interdisciplinary context, most studies do not incorporate interdisciplinary training that includes physicians and nurses.
This is a randomized trial of a communication skills workshop for internal medicine residents and nurse practitioner (NP) students. A total of 373 residents and 128 NP students from two large training programs (UW and MUSC) will be randomized to either the intervention or usual education. The study's primary outcome measure will be the QOC scores on the "communication about end-of-life care" domain. The QOC will be assessed by patients, family members, and nurses before and after the intervention time period for all trainees. Secondary outcome measures are patient symptoms and patient-, family - and nurse-assessed QEOLC scores. Outcome measures will be collected for 5 patients and family members per trainee before the intervention period and 5 patients and family members per trainee after the intervention period. Process measures for both residents and NP students will include pre- and post-intervention assessment of knowledge, attitudes, and behavior regarding communication using standardized patient assessment as well as self-assessment and faculty assessment.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Physician:
NP Student:
Patient:
One or more of the following diagnostic criteria:
Family:
Nurse-evaluators:
Exclusion Criteria:
Contacts and Locations| Contact: J. Randall Curtis, MD, MPH | 206-744-3356 | jrc@u.washington.edu |
| United States, South Carolina | |
| Medical University of South Carolina | Recruiting |
| Charleston, South Carolina, United States, 29425 | |
| United States, Washington | |
| University of Washington; Harborview Medical Center | Recruiting |
| Seattle, Washington, United States, 98104 | |
| University of Washington; UW Medical Center | Recruiting |
| Seattle, Washington, United States, 98195 | |
| Veteran's Affairs Puget Sound HCS | Recruiting |
| Seattle, Washington, United States, 98108 | |
| Principal Investigator: | J. Randall Curtis, MD, MPH | University of Washington, Div. of Pulmonary and Critical Care Medicine |
More Information
| Responsible Party: | Dr. J. Randall Curtis, University of Washington, Division of Pulmonary and Critical Care Medicine |
| ClinicalTrials.gov Identifier: | NCT00687349 History of Changes |
| Other Study ID Numbers: | 31466-G, R01NR009987, R01 NR009987 |
| Study First Received: | May 28, 2008 |
| Last Updated: | March 24, 2011 |
| Health Authority: | United States: Federal Government |
|
End-of-Life issues Talking with your doctor Coping with chronic illness |
|
Heart Failure Liver Diseases Lung Diseases Pulmonary Disease, Chronic Obstructive Lung Diseases, Obstructive End Stage Liver Disease Neoplasms |
Heart Diseases Cardiovascular Diseases Digestive System Diseases Respiratory Tract Diseases Liver Failure Hepatic Insufficiency |
