Training supported by simulated persons to promote the development of specific communication skills in advance care planning.

Abstract

Objectives: Advance care planning (ACP) has been conceived to ensure that patients who are unable to consent are treated in consistence with their well-informed, predetermined preferences. At an individual level, standardised conversations are offered by specifically qualified healthcare professionals (ACP facilitators). Internationally, there is considerable variability with regard to ACP qualifications. This article describes how ACP facilitators are trained in role plays employing simulated persons (SPs) in accordance with the standards of two professional societies.

Methods: ACP experts developed ten roles in cooperation with an SP coach (director) based on real ACP conversations. The emotional and mental world of the role, ACP-relevant facts such as previous experience in the medical context, and aids for acting were developed, taking into account the central challenges in ACP conversations. To ensure standardisation, the SPs rehearsed in a structured manner and received feedback training. Microteaching techniques were developed for the facilitator training.

Results: Feedback skills and openness towards the topics of serious illness, dying and death are required for the SP to be suitable. Since 2017, ACP facilitator training has taken place in small groups of four participants, one SP and one qualified ACP coach. The required framework is described in detail.

Conclusion: SP-supported training is a decisive improvement for the teaching and assessment of the highly complex ACP-facilitation skills and attitudes. Planning and implementation place high demands on SP and ACP coaches who also require specific qualifications.