Virtual NephroTalk: Teaching Communication Skills During the COVID-19 Pandemic

ABSTRACT

Background: Nephrologists engage in advance care planning with their patients less often than other specialists caring for patients with similarly life-limiting illnesses, and many patients with kidney disease receive invasive care that may not be consistent with their wishes. The UPMC NephroTalk curriculum has previously been shown to increase both self-rated preparedness and objective performance of essential communication skills to help prepare nephrology fellows to discuss goals of care with patients and families. The COVID-19 pandemic has necessitated innovation in teaching communication skills. We adapted the NephroTalk curriculum to provide the opportunity to acquire and practice communication skills while learning remotely. Method(s) Nephrology fellows from 4 ACGME-accredited nephrology programs, as well as other renal healthcare professionals participated in a three-day virtual course with synchronous and asynchronous components including 1) self-paced modules explaining and demonstrating communication skills;2) small group drills to promote deliberate practice of core skills led by experienced facilitators;and 3) small group practice with simulated patients incorporating peer and facilitator feedback. Surveys measured participants' self-perceived communication preparedness pre- and post-curriculum and satisfaction with the program. Result(s) Twenty-two healthcare professionals participated in the virtual NephroTalk curriculum over two years. Prior to the course, most learners described feeling "not prepared" or "somewhat prepared" on a 5-point Likert scale to perform 12 key communication skills including discussing prognosis, eliciting patient values, discussing conservative kidney management, and recommending a treatment plan. After completing the program, 100% of participants reported feeling "prepared" or "very prepared" to perform all 12 communication skills. Respondents expressed a high degree of satisfaction with the course overall. Conclusion(s) The COVID-19 pandemic has resulted in a shift toward virtual learning within medical education. Nephrology fellows and clinicians participating in the virtual NephroTalk curriculum expressed high levels of satisfaction and preparedness to utilize the skills demonstrated in the course. Future research should evaluate the impact of virtual communication skills training on sustained skill maintenance over time and patient outcomes.