Program helps kidney specialists discuss difficult news with patients

Kidney specialists, or nephrologists, care for a medically complex population and frequently must discuss serious news with patients: giving a diagnosis of kidney disease, explaining the risks and benefits of treatments, and defining care goals at the end of life. Yet nephrologists do not routinely receive formal education on how to engage in these types of conversations. A new communication skills workshop for nephrology fellows could change that, according to a study appearing in an upcoming issue of the Clinical Journal of the American Society of Nephrology (CJASN).

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 initiation and withdrawal.
  • All respondents reported that they would recommend this training to other fellows.
  • 95% said the should be required of all nephrology fellows.
"Communication is central to what we do as physicians. Our goal is for NephroTalk to serve as a model curriculum for enhancing communication education within nephrology training," said Dr. Schell.

More information: The article, entitled "Communication Skills Training for Dialysis Decision-Making and End of Life Care in Nephrology," will appear online on November 8, 2012, doi: 10.2215/05220512

Related Stories

US medical students are rejecting kidney careers

date May 05, 2011

Kidney disease affects 1 in 9 US adults, and by 2020 more than 750,000 Americans will be on dialysis or awaiting kidney transplant. Despite this growing health problem, every year fewer US medical students adopt nephrology ...

The cost of improving dialysis care

date Nov 02, 2009

Improving survival among dialysis patients may increase treatment costs significantly, according to a paper being presented at the American Society of Nephrology's 42nd Annual Meeting and Scientific Exposition in San Diego, ...

Model predicts dialysis patients' likelihood of survival

date Dec 03, 2009

A new model can help physicians determine if a kidney disease patient on dialysis is likely to die within the next few months, according to a study appearing in an upcoming issue of the Clinical Journal of ...

Recommended for you

2015 match sees high proportion of unmatched seniors

date Mar 30, 2015

(HealthDay)—About 6.1 percent of U.S. allopathic medical school seniors in the National Resident Matching Program (NRMP) were not placed into first-year residency positions, with a higher percentage of ...

What to do with kidneys from older deceased donors?

date Mar 26, 2015

A new study highlights the best way to use kidneys from older deceased donors, providing the most benefits to patients and addressing the worsening organ shortage. The study's findings, which appear in an upcoming issue of ...

User comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.