GITalk: Communication Skills Training for Gastroenterology Fellows Improves Self-Assessed Preparedness for Serious Illness Conversations

Abstract

Background Despite caring for conditions associated with high symptom burden and mortality, GI fellows rarely receive communication training. Aims To describe the development, implementation, and assessment of GITalk, a novel communication curriculum for gastroenterology (GI) fellows. Methods GITalk was designed to improve the skills needed to have effective serious illness conversations frequently encountered in clinical practice. Participants practiced encounters using two cases with simulated actors. One case involved delivering news that a patient with decompensated cirrhosis will no longer be a candidate for liver transplant, and the second case involved counseling the family of a patient with moderate to severe dementia on the risks and benefits of inserting a percutaneous feeding tube for artificial enteral nutrition. Results Annual training sessions were held for four consecutive years, representing a total of 23 GI fellows. Prior to participation in GITalk, few participants reported having had prior formal teaching in serious illness conversations. Paired sample t-tests showed that participants had significantly higher mean post-training preparedness scores compared to pre-training across all 9 survey questions. 91% of participants strongly agreed with the statement: “I would recommend this training to other fellows.” 78% strongly agreed with, “This training should be required of all GI fellows.” Conclusions Participants had little formal training in serious illness conversation prior to participation in GITalk. They reported substantial improvement in their self-assessed preparedness for discussing common clinical scenarios encountered in gastroenterology. GITalk can serve as a model for improvements in the Interpersonal and Communication Skills core competency for gastroenterology trainees.