Sustained Effect of Serious Illness Communication Skills Training on Clinicians' Self-Preparedness in Brain-Death Organ Donation Decision-Making.

Abstract

Background: Clinicians in Japan often report difficulty communicating with families about brain-death organ donation, which may contribute to challenges in supporting families' decision-making at the end of life. Objectives: To evaluate the impact of a structured serious illness communication workshop on clinicians' self-reported preparedness to engage in donation-related conversations. Design: Prospective single-arm educational intervention with repeated measures. Setting/Subjects: Two synchronous web-based workshops were conducted with physicians and nurses from various departments across 13 hospitals in Japan. A total of 58 clinicians participated, and 44 (76%) completed all three surveys. Measurements: Self-preparedness for the 12 core communication tasks was assessed using a five-point Likert scale at baseline, immediately after the course, and 8 weeks later. Repeated-measures ANOVA and Bonferroni-adjusted paired t-tests were used to assess changes over time. Results: Preparedness scores improved significantly across all domains immediately after the course (mean increase: 0.48-1.00; all p < 0.01) and were sustained at 8 weeks. In particular, self-perceived preparedness to discuss brain-death organ donation improved from a mean of 2.4 at baseline to 3.3 post-course (p < 0.001) and remained stable at follow-up. Conclusions: A virtual communication workshop significantly and durably enhanced Japanese clinicians' preparedness to engage in brain-death organ donation discussions. Incorporating such training in clinical education may improve the quality and frequency of end-of-life communication.