Does Predictive Prompting Improve Future Specialists’ Self evaluation of Communication Skills During End of Life Conversations?

Abstract

Abstract In healthcare, effective communication in complex situations such as end of life conversations is critical for delivering high quality care. Whether future specialists learn from communication training with actors depends on whether they are able to select appropriate information or ‘predictive cues’ from that learning situation that accurately reflect their performance and whether they use those cues for ensuing self-judgement. This study aimed to explore whether cue prompts can help residents focusing on predictive cues and improving monitoring accuracy of their communication skills. First and third year Kenyan residents (N = 41) from 8 different specialties were randomly assigned to one of two experimental groups (predictive cue prompt versus control group receiving regular prompts) during a mock OSCE assessing communication skills. The use of predictive cues and the appropriateness of judgements of satisfaction were evaluated against a pre-rated video and compared before and after the intervention and across groups. The intervention improved the use of predictive cues from pre to post test. Ensuing monitoring accuracy only partly improved: no effect from the intervention was found on overall appropriateness of judgements. However, when analyzing participants’ completeness of judgements over the various themes within the consultation, a reduction in inappropriate judgments scores was seen in the intervention group. In conclusion, predictive cue prompts can help learners to concentrate on relevant cues when evaluating their communication skills and partly improve learners’ monitoring accuracy. Future research should focus on offering prompts more frequently to evaluate whether this increases the effect on monitoring accuracy in communication skills.