To address the need for structured communication training in nephrology programs, Jane Schell, MD (University of Pittsburgh) and her colleagues designed a formal workshop, called NephroTalk, aimed at providing nephrology fellows with communication skills in discussing dialysis decision-making and end-of-life care. The workshop, modeled after a national oncology workshop called OncoTalk, is comprised of educational sessions on delivering bad news and defining goals of care when a patient is not doing well. It involves small group sessions with standardized patients. The skills that are taught and practiced include assessing patient understanding before giving news, recognizing and responding to patients' emotional concerns, and eliciting patients' goals and end-of-life preferences.
The workshop was offered to 22 nephrology fellows at Duke University and the University of Pittsburgh. Surveys conducted before and dafter the workshop revealed the following:
- The average level of perceived preparedness significantly increased for all skills, including delivering bad news, expressing empathy, and discussing dialysis initiation and withdrawal.
- All respondents reported that they would recommend this training to other fellows.
- 95% said the workshop should be required of all nephrology fellows.