Providing Virtual Support to Children With Mild Developmental Delays in Response to the Pandemic

The COVID-19 pandemic has had massive impacts across the globe. Children with developmental delays are an increasingly vulnerable population, highlighting the importance of ensuring they have access to high-quality virtual services during this time. The Early Discovery program currently provides therapeutic interventions for children with mild developmental delays. We sought to compare the outcomes of 2 cohorts within the Early Discovery program using different delivery approaches (n = 238 families): children who received services in person before the pandemic (n = 126) and children who received services via telehealth in the acute phase of the pandemic (n = 112). Both groups of children showed significant improvements in language skills posttreatment, and, with regard to auditory comprehension, both groups showed similar rates of improvement. However, children receiving in-person services before the pandemic showed greater improvements in expressive communication skills than children receiving telehealth services during the pandemic. Results indicate that the Early Discovery program was able to make adjustments during the pandemic that assisted families in maintaining progress in improving their child's language skills.

Virtual Geritalk: Does Intensive Virtual Communication Skills Training Improve Use of Serious Illness Communication Skills?

Background: The COVID-19 pandemic presented a unique opportunity to adapt in-person communication skills training to a virtual format. Objective: Examine use of serious illness communication skills by learners after participating in an intensive virtual communication skills training. Design: Prospective cohort study. Setting/Subjects: Icahn School of Medicine at Mount Sinai, Clinical Fellows. Measurements: Family Meeting Communication Assessment Tool (FAMCAT) assessed fundamental and advanced communication skills. Results: As compared to a historical benchmark obtained after a prior in-person course, the virtual course showed equivalent or better use of communication skills across fundamental skills and advanced skills. Conclusions: Our findings suggest that a virtual communication skills training is associated with the use of serious illness communication skills in the clinical setting by learners.

Business English for international working professionals: A virtual training focusing on intercultural communication skills

Without intercultural communication skills, an unbalanced power-dynamic will continue to affect the success of individuals, organizations, and societies in the global market. The COVID-19 crisis has revealed an urgent demand for virtual learning opportunities for working professionals. This instrumental qualitative case study documented the experiences of a group of international working professionals participating in a virtual international business English training. Drawing on intercultural communicative competence and experiential e-learning models, the study documented innovative practices designing and implementing the training, the experiences of the working professionals who participated in the training, and how the training enhanced the working professionals' intercultural communication skills. Data collected included online questionnaires, artifacts, videoconference interviews, and the research journal. Data analysis for the study followed Braun and Clarke's (2006) thematic analysis process. As a result, dissertation findings identified innovative practices for designing and implementing a virtual international business English training program for working professionals centering attention on intercultural communication. The study bridged the gap between existing knowledge and instructional practices in teaching English to speakers of other languages. Incorporating experiential learning was a novel insight into improving the theoretical models utilized in the study. Learner confidence as an important factor in improving language and intercultural communication was another notable finding. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Psychological factors and communication skills training in intensive care medical staff

Background. Intensive care settings have been shown to present a demanding work setting with health related and work-related consequences for intensive care medical staff. The health-related consequences observed are high levels of burnout, traumatic stress, symptoms of anxiety, depression, and fatigue. Specific stressors mentioned by staff is high workload, moral distress, end-of-life issues, and interpersonal issues/conflicts with colleagues, patients, and relatives. During the covid-19 pandemic, the need for healthcare organizations to attend to the occupational psychological health of staff has been evidently clear. Although, the prevalence of stress in intensive care has been previously observed and reported on, at least since the 70s.Purpose and aims. Overall purpose of thesis was threefold;to improve knowledge on occupational psychological health among healthcare staff, particularly in intensive care settings, to develop a behavioural intervention to improve communication skills and management of distress to enhance occupational health, and to evaluate the implementation of psychological support to ICU staff. The thesis included four studies and the specific aim of study I was to evaluate the reliability and validity of a Swedish version of the Work-related Acceptance and Action Questionnaire (WAAQ), a self-report questionnaire measuring psychological flexibility at work. Study II evaluated the relationship between psychological flexibility (measured by WAAQ) and other aspects of occupational psychological health, i.e., perceived stress, general mental health, and work engagement, in a sample of intensive care medical staff. Study III evaluated the effects of a Behavioral Skills Training (BST) program on dependent measures of occupational psychological health in a sample of intensive care medical staff. Finally, study IV evaluated the implementation and feasibility of a psychological support model rapidly developed and implemented for ICU staff during the first wave of the covid-19 pandemic.Methods. Four studies were included in the thesis. Study I used a cross-sectional design to evaluate reliability and validity of a measure of psychological flexibility, WAAQ, in a sample of healthcare professionals. In a subsample of participants, a longitudinal design was used to evaluate test-retest reliability. Measures used in the study were three self-report questionnaires, WAAQ, PSS-10 (Perceived Stress Scale-10), and UWES (Utrecht Work Engagement Scale) and the sample consisted of 184 healthcare professionals. Study II evaluated the relationship between psychological flexibility (WAAQ), work engagement(UWES), perceived stress (PSS-10), and general mental health (GHQ-12) in a cross-sectional design in a sample of intensive care medical staff. A longitudinal design was used in a subsample (n=46) to further evaluate the relationship between WAAQ and UWES. Study III evaluated the effects of the BST program in a pre-post uncontrolled trial with three assessment points (pre, mid, and post). Study IV used a cross-sectional and qualitative design to evaluate implementation of the support model.Results. In study I, WAAQ showed good internal consistency and good test-retest reliability. Furthermore, it showed a significant negative relationship with perceived stress and significant positive relationship with work engagement. In study II, a hierarchical regression analysis showed WAAQ to explain variance in UWES when controlling forPSS-10 and GHQ-12. Additionally, WAAQ had a significant indirect effect on the relationship between perceived stress (PSS-10) and work engagement (UWES), and the relationship between general mental health (GHQ-12) and work engagement (UWES). (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Psychological factors and communication skills training in intensive care medical staff

Background. Intensive care settings have been shown to present a demanding work setting with health related and work-related consequences for intensive care medical staff. The health-related consequences observed are high levels of burnout, traumatic stress, symptoms of anxiety, depression, and fatigue. Specific stressors mentioned by staff is high workload, moral distress, end-of-life issues, and interpersonal issues/conflicts with colleagues, patients, and relatives. During the covid-19 pandemic, the need for healthcare organizations to attend to the occupational psychological health of staff has been evidently clear. Although, the prevalence of stress in intensive care has been previously observed and reported on, at least since the 70s.Purpose and aims. Overall purpose of thesis was threefold;to improve knowledge on occupational psychological health among healthcare staff, particularly in intensive care settings, to develop a behavioural intervention to improve communication skills and management of distress to enhance occupational health, and to evaluate the implementation of psychological support to ICU staff. The thesis included four studies and the specific aim of study I was to evaluate the reliability and validity of a Swedish version of the Work-related Acceptance and Action Questionnaire (WAAQ), a self-report questionnaire measuring psychological flexibility at work. Study II evaluated the relationship between psychological flexibility (measured by WAAQ) and other aspects of occupational psychological health, i.e., perceived stress, general mental health, and work engagement, in a sample of intensive care medical staff. Study III evaluated the effects of a Behavioral Skills Training (BST) program on dependent measures of occupational psychological health in a sample of intensive care medical staff. Finally, study IV evaluated the implementation and feasibility of a psychological support model rapidly developed and implemented for ICU staff during the first wave of the covid-19 pandemic.Methods. Four studies were included in the thesis. Study I used a cross-sectional design to evaluate reliability and validity of a measure of psychological flexibility, WAAQ, in a sample of healthcare professionals. In a subsample of participants, a longitudinal design was used to evaluate test-retest reliability. Measures used in the study were three self-report questionnaires, WAAQ, PSS-10 (Perceived Stress Scale-10), and UWES (Utrecht Work Engagement Scale) and the sample consisted of 184 healthcare professionals. Study II evaluated the relationship between psychological flexibility (WAAQ), work engagement(UWES), perceived stress (PSS-10), and general mental health (GHQ-12) in a cross-sectional design in a sample of intensive care medical staff. A longitudinal design was used in a subsample (n=46) to further evaluate the relationship between WAAQ and UWES. Study III evaluated the effects of the BST program in a pre-post uncontrolled trial with three assessment points (pre, mid, and post). Study IV used a cross-sectional and qualitative design to evaluate implementation of the support model.Results. In study I, WAAQ showed good internal consistency and good test-retest reliability. Furthermore, it showed a significant negative relationship with perceived stress and significant positive relationship with work engagement. In study II, a hierarchical regression analysis showed WAAQ to explain variance in UWES when controlling forPSS-10 and GHQ-12. Additionally, WAAQ had a significant indirect effect on the relationship between perceived stress (PSS-10) and work engagement (UWES), and the relationship between general mental health (GHQ-12) and work engagement (UWES). (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Improving transitional care through online communication skills training.

BACKGROUND: As the aging population is increasing significantly, the communication skills training (CST) on transitional care (TC) is insufficient. AIMS: This study aimed to test the effectiveness of an intervention (the online TC CST [OTCCST] and TC) through the perspectives of healthcare providers (HCPs), older patients, and family members. METHODS: A total of 38 HCPs caring for older patients were randomized to the experimental (n = 18) or control groups (n = 20), and 84 pairs of patients and family members were enrolled (experimental: n = 42 vs. control: n = 42). The primary outcome was HCP communication confidence; while secondary outcomes included patient quality of life (QoL), activities of daily living (ADL), rehospitalization counts, and family caregiving burden. Data were collected from HCPs using a scale measuring confidence in communicating with patients. Patient outcomes were assessed using the McGill QoL Questionnaire-Revised and Barthel Index. Family members were assessed with the Caregiver Burden Inventory. Rehospitalization counts were tracked for 3 months post-discharge. Data were analyzed using multiple regression analysis. RESULTS: Experimental group HCPs showed a significant improvement in communication confidence over the control group (p = 0.0006). Furthermore, experimental group patients had significantly fewer rehospitalization counts within 3-month post-discharge (p < 0.05). However, no significant group differences were found in patient QoL and ADL nor in family caregiver burden. CONCLUSION: The OTCCST can effectively improve HCP communication confidence, and the combination of OTCCST and TC can reduce rehospitalization counts for older patients. The OTCCST allows HCPs to learn asynchronously at their convenience, ideal for continuing education, especially during the COVID-19 pandemic.

TURNING CONSTRAINTS INTO OPPORTUNITIES: ONLINE DELIVERY OF COMMUNICATION SKILLS SIMULATION SESSIONS TO UNDERGRADUATE MEDICAL STUDENTS DURING THE COVID-19 PANDEMIC

The COVID-19 pandemic impacted higher-learning institutions. Communication skills training in medical education needed innovative solutions to adjust to the situation. In times of change, evaluation channels should be developed, and any problems raised by learners and educators should be responded to rapidly. A remotely facilitated communication skills simulation-based training programme was piloted by the clinical skills laboratory tutors using Zoom as the online platform. The goal of the pilot session was to establish a communication skills training strategy remotely, to test an online session using the defined online platform and to assess its effectiveness. Though locally facilitated face-to-face simulation-based training as the conventional format is easier to use and experience, training on virtual simulation-based communication skills enabled through the online portal has been described by participants as both feasible and effective. The results show that an efficient educational environment can be provided by remote simulation of communication skills. An important requirement for learner engagement with remotely facilitated simulation-based training is the development of contextual understanding, multiple exposures and a respectful learner-teacher relationship. Any negative impact of remotely facilitated simulation-based training may be concealed by an overarching high perceived value of simulation-based trainings in general. This pilot online simulation programme shows the value of using this modality and lays the foundation for communication skills teaching during future disasters. There is the need to consider how online simulation can be sustained after the pandemic and not just returning to the conventional face-to-face teaching and learning.

TURNING CONSTRAINTS into OPPORTUNITIES: ONLINE DELIVERY of COMMUNICATION SKILLS SIMULATION SESSIONS to UNDERGRADUATE MEDICAL STUDENTS during the COVID-19 PANDEMIC

The COVID-19 pandemic impacted higher-learning institutions. Communication skills training in medical education needed innovative solutions to adjust to the situation. In times of change, evaluation channels should be developed, and any problems raised by learners and educators should be responded to rapidly. A remotely facilitated communication skills simulation-based training programme was piloted by the clinical skills laboratory tutors using Zoom as the online platform. The goal of the pilot session was to establish a communication skills training strategy remotely, to test an online session using the defined online platform and to assess its effectiveness. Though locally facilitated face-to-face simulation-based training as the conventional format is easier to use and experience, training on virtual simulation-based communication skills enabled through the online portal has been described by participants as both feasible and effective. The results show that an efficient educational environment can be provided by remote simulation of communication skills. An important requirement for learner engagement with remotely facilitated simulation-based training is the development of contextual understanding, multiple exposures and a respectful learner-teacher relationship. Any negative impact of remotely facilitated simulation-based training may be concealed by an overarching high perceived value of simulation-based trainings in general. This pilot online simulation programme shows the value of using this modality and lays the foundation for communication skills teaching during future disasters. There is the need to consider how online simulation can be sustained after the pandemic and not just returning to the conventional face-to-face teaching and learning. © Creative Commons With Attribution (CC-BY)

TeleCPT: Delivery of a Better Conversations Approach to Communication Partner Training During a Global Pandemic and Beyond

Purpose: This case report provides an overview of telehealth delivery of our Better Conversations approach to communication partner training (CPT) for people with primary progressive aphasia (PPA) and their communication partner (CP). The purpose is to advance the knowledge of speech and language therapists/pathologists (SLTs) on this type of CPT and empower them to deliver teleCPT as part of their clinical practice. Method: We provide a case report describing therapy delivery, outcomes, and self-reflections from our clinical practice, which represents a collaboration between a UK National Health Service CPT clinic and the Better Conversations Research Lab at University College London, UK. A man with PPA and his CP (a dyad) video-recorded everyday conversations at home using a video conferencing platform. These formed the basis of an evaluation of conversation barriers and facilitators, which led to four weekly 1-hr therapy sessions covering the mechanics of conversation, identification of barriers and facilitators, goal setting, and practice of positive conversation strategies. Results: Dyad self-rating of goal attainment revealed that three of four conversation strategies were achieved much more than expected, a positive outcome given the progressive nature of F.F.'s condition. SLT access to the dyad at home via teleCPT facilitated the carryover of strategies from the session to everyday conversations in the home environment. TeleCPT was acceptable to this couple during a global pandemic, with benefits including no travel, ease of therapy scheduling around the CP's work and family commitments, and access to a specialist CPT clinic outside their geographical area. Conclusions: TeleCPT is feasible and acceptable to clients, improving access to therapy in a way that should not just be the preserve of service delivery during a global pandemic. SLTs can enable clients and their families to have better conversations despite communication difficulties by offering teleCPT. We have shared practical suggestions for delivering teleCPT.

Virtual Geritalk: Improving Serious Illness Communication of Clinicians Who Care for Older Adults.

CONTEXT: High quality communication is essential to older adults' medical decision-making, quality of life, and adjustment to serious illness. Studies have demonstrated that Geritalk, a two day (16 hours total) in-person communication skills training improves self-assessed preparedness, skill acquisition, and sustained practice of communication skills. Due to the COVID-19 pandemic, Geritalk was adapted to a virtual format (four days, 10 hours total). OBJECTIVES: Our study evaluated the change in participants' self-assessed preparedness for serious illness communication before and after the virtual course and satisfaction with the course, and compared these findings to responses from a prior in-person Geritalk course. METHODS: Geriatrics and Palliative Medicine fellows at three urban academic medical centers completed surveys, which employed five-point Likert scales, before and after the virtual course to assess satisfaction with the course and preparedness for serious illness communication. RESULTS: Of the 20 virtual Geritalk participants, 17 (85%) completed the pre-course assessment, and 14 (70%) completed the post-course assessment. Overall, satisfaction with the course was high (mean 4.9 on a 5-point scale). Compared to in-person Geritalk participants, virtual course participants reported comparable and significant (P < 0.01) improvements in mean self-reported preparedness across all surveyed communication skills. CONCLUSION: We show that a virtual communication skills training is feasible and effective. Our findings suggest that the innovative virtual Geritalk course has the potential to increase access to communication skills training, improve serious illness communication skills, and in improve the quality of care received by older adults with serious illness.

Communicating Effectively via Tele-oncology (Comskil TeleOnc): a Guide for Best Practices for Communication Skills in Virtual Cancer Care.

The emergence of a novel coronavirus (SARS-CoV-2, causing coronavirus disease 2019 or COVID-19) has disrupted the US medical care system. Telemedicine has rapidly emerged as a critical technology enabling health care visits to continue while supporting social distancing to reduce the risk of COVID-19 transmission among patients, families, and clinicians. This model of patient care is being utilized at major cancer centers around the USA-and tele-oncology (telemedicine in oncology) has rapidly become the primary method of providing cancer care. However, most clinicians have little experience and inadequate training in this new form of care delivery. Because many practicing oncology clinicians are not familiar with telemedicine technology and the best practices for virtual communication, we strongly believe that training in this field is essential. Utilizing best practices of communication skills training, this paper presents a brief tele-oncology communication guide (Comskil TeleOnc) to address the timely need to maximize high-quality care to patients with cancer. The goal of the Comskil TeleOnc Guide is to recognize, elicit, and effectively respond to patients' medical needs and concerns while utilizing empathic responses to communicate understanding, alleviate distress, and provide support via videoconferencing. We recommend five strategies to achieve the communication goal outlined above: (1) Establish the clinician-patient relationship/create rapport, (2) set the agenda, (3) respond empathically to emotions, (4) deliver the information, and (5) effectively end the tele-oncology visit. The guide proposed in this paper is not all-encompassing and may not be applicable to all health care institutions; however, it provides a practical, patient-centered framework to conduct a tele-oncology visit.

To zoom or not to zoom - the training of communicative competencies in times of Covid 19 at Witten/Herdecke University illustrated by the example of "sharing information".

Since October 2018, a longitudinal communication curriculum for medical students has been implemented at Witten/Herdecke University. In the summer semester 2020, the concept for the 4th preclinical semester included a practical training on "sharing information", which consisted of three two-hour face-to-face sessions with simulated patients (SP). Due to the Covid 19 pandemic, teaching was changed to an inverted classroom concept combining asynchronous and synchronous teaching. The students worked at the beginning of the semester on an e-learning module of the learning platform docCom.deutsch on the topic "sharing information" using reflection and processing tasks. In two digital sessions, the students then were able to practice discharge interviews and discussions about risk communication illustrated by the example of screening methods for cancer prevention. In the first zoom session, students practiced in role-plays among themselves. In the second zoom session, they practiced with SP. The evaluation results revealed that 76% of the responding students considered working with the e-learning module as a good preparation for the interviews. According to the evaluation results, satisfaction with the Zoom meeting including SP contact was slightly higher than those with role-plays among themselves. Although the group atmosphere was rated by all responding students as conducive to learning, almost half of them confirmed that using Zoom significantly impaired the atmosphere (47%). In retrospect, the conversion of the communication training to a digital format worked better than expected from both the perspective of teachers and students. The students explicitly appreciated working with SP. From the teachers' perspective, some specific aspects of successful communication were difficult to reflect on, e.g. non-verbal communication. The use of e-learning as a preparation for practical exercises has proven successful and will be continued in the future.