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What can we learn from simulation-based training to improve skills for end-of-life care? Insights from a national project in Israel

Overview of attention for article published in Israel Journal of Health Policy Research, November 2017
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  • Above-average Attention Score compared to outputs of the same age (51st percentile)
  • Above-average Attention Score compared to outputs of the same age and source (56th percentile)

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6 X users

Citations

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199 Mendeley
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Title
What can we learn from simulation-based training to improve skills for end-of-life care? Insights from a national project in Israel
Published in
Israel Journal of Health Policy Research, November 2017
DOI 10.1186/s13584-017-0169-9
Pubmed ID
Authors

Mayer Brezis, Yael Lahat, Meir Frankel, Alan Rubinov, Davina Bohm, Matan J Cohen, Meni Koslowsky, Orit Shalomson, Charles L Sprung, Henia Perry-Mezare, Rina Yahalom, Amitai Ziv

Abstract

Simulation-based training improves residents' skills for end-of-life (EOL) care. In the field, staff providers play a significant role in handling those situations and in shaping practice by role modeling. We initiated an educational intervention to train healthcare providers for improved communication skills at EOL using simulation of sensitive encounters with patients and families. Hospital physicians and nurses (n = 1324) attended simulation-based workshops (n = 100) in a national project to improve EOL care. We analyzed perceptions emerging from group discussions following simulations, from questionnaires before and after each workshop, and from video-recorded simulations using a validated coding system. We used the simulation setting as a novel tool for action research. We used a participatory inquiry paradigm, with repetitive cycles of exploring barriers and challenges with participants in an iterative pattern of observation, discussion and reflection - including a description of our own responses and evolution of thought as well as system effects. The themes transpiring included lack of training, knowledge and time, technology overuse, uncertainty in decision-making, poor skills for communication and teamwork. Specific scenarios demonstrated lack of experience at eliciting preferences for EOL care and at handling conflicts or dilemmas. Content analysis of simulations showed predominance of cognitive utterances - by an order of magnitude more prevalent than emotional expressions. Providers talked more than actors did and episodes of silence were rare. Workshop participants acknowledged needs to improve listening skills, attention to affect and teamwork. They felt that the simulation-based workshop is likely to ameliorate future handling of EOL situations. We observed unanticipated consequences from our project manifested as a field study of preparedness to EOL in nursing homes, followed by a national survey on quality of care, leading to expansion of palliative care services and demand for EOL care education in various frameworks and professional areas. Reflective simulation exercises show barriers and paths to improvement among staff providers. When facing EOL situations, physicians and nurses use cognitive language far more often than emotions related expressions, active listening, or presence in silence. Training a critical mass of staff providers may be valuable to induce a cultural shift in EOL care.

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X Demographics

The data shown below were collected from the profiles of 6 X users who shared this research output. Click here to find out more about how the information was compiled.
Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 199 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 199 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 30 15%
Student > Bachelor 27 14%
Researcher 18 9%
Student > Ph. D. Student 11 6%
Student > Postgraduate 9 5%
Other 35 18%
Unknown 69 35%
Readers by discipline Count As %
Nursing and Health Professions 51 26%
Medicine and Dentistry 29 15%
Psychology 10 5%
Biochemistry, Genetics and Molecular Biology 5 3%
Social Sciences 5 3%
Other 19 10%
Unknown 80 40%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 3. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 07 August 2018.
All research outputs
#13,057,881
of 23,007,053 outputs
Outputs from Israel Journal of Health Policy Research
#189
of 580 outputs
Outputs of similar age
#156,504
of 330,777 outputs
Outputs of similar age from Israel Journal of Health Policy Research
#10
of 23 outputs
Altmetric has tracked 23,007,053 research outputs across all sources so far. This one is in the 42nd percentile – i.e., 42% of other outputs scored the same or lower than it.
So far Altmetric has tracked 580 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 5.5. This one has gotten more attention than average, scoring higher than 65% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 330,777 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 51% of its contemporaries.
We're also able to compare this research output to 23 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 56% of its contemporaries.