"Acquiring the Skills Needed to Communicate What Is in Our Teams' Heart: Love, Compassion and Partnership": Qualitative Analysis of Intact Multidisciplinary Teams' Experience of Relationship-Centered Communication Training.

The Partnership Enhancement Program (PEP) is a 6-hour relationship-centered communication training for intact cystic fibrosis (CF) teams. The aim of this study was to analyze qualitative responses from survey participants regarding their takeaways from the training. A total of 210 professionals participated in 20 pilot workshops at 19 care centers in the United States from November 2018 to December 2019. After the workshop, qualitative feedback was captured by PEP facilitators during a feedback gathering session or submitted immediately in writing by participants. The manuscript team used grounded theory and qualitative methods of coding to identify recurring themes across participant responses. Thematic analysis revealed 5 primary themes and a web of interconnected subthemes. Primary themes include the acquisition of skills to improve communication, strengthened patient/provider connection, improved quality of communication, improved team building, and the ability to change and enhance practice. Participants who completed PEP training endorse acquiring communication skills that increase coproduction of care with patients and caregivers as well as improve relationships across the healthcare system.

Generating Ecotrust: A Relational Response to the Infodemic.

Trust has been studied by a variety of disciplines and perspectives, with many pointing towards the need for a more complex and dynamic approach to understanding trust as a relational process. This paper introduces the concept of ecotrust within healthcare as means to capture a co-produced, relational response to the abundance of (mis)information produced by the current infodemic. As an approach that recognizes the contributions of and impact on all members of the system, ecotrust encourages research that explores the process by which trust emerges as a shared reality from both the provider's or healthcare team's perspectives, as well as the patient experience, potentially leading to new conversations and strategies for partnering together. Finally, ecotrust encourages the skills of relationship-centered communication as a specific strategy for entering conversations with curiosity and empathy, thus encouraging relationship-building as a humanistic first step for responding to (mis)information.

"For Me, This Has Been Transforming": A Qualitative Analysis of Interprofessional Relationship-Centered Communication Skills Training.

In 2018, Yale Medicine (YM)-an academic multispecialty practice-and Yale New Haven Health System (YNHH), partnered with the Academy of Communication in Healthcare to develop a one-day interprofessional workshop to introduce relationship-centered communication skills to all of their nurses and physicians. Relationship-centered communication skills include showing positive regard, listening actively and expressing empathy and have been demonstrated to improve patient outcomes. A professionally diverse group of 12 nurses and physicians, committed to improving patient experiences, were purposefully selected for training to teach the workshop. Individual interviews with trainers 3 months post training revealed themes reflecting the intrapersonal, interpersonal, and organizational impact of participation in the Train-the-Trainer program. At the intrapersonal level, training contributed to personal growth, skillfulness, and confidence. At the interpersonal level, it expanded and strengthened professional networks. As an organizational catalyst, training transformed the work experience among nurse and physician trainers, thereby supporting YM/YNHH's vision to provide interprofessional relationship-centered care. Results suggest that trainer training had additional benefits beyond learning to deliver the workshop, including improving the quality of trainers' personal and professional relationships, and enhancing organizational efficiency and interprofessionalism.

The impact of a faculty learning community on professional and personal development: the facilitator training program of the American Academy on Communication in Healthcare.

PURPOSE: Relationship-centered care attends to the entire network of human relationships essential to patient care. Few faculty development programs prepare faculty to teach principles and skills in relationship-centered care. One exception is the Facilitator Training Program (FTP), a 25-year-old training program of the American Academy on Communication in Healthcare. The authors surveyed FTP graduates to determine the efficacy of its curriculum and the most important elements for participants' learning. METHOD: In 2007, surveys containing quantitative and narrative elements were distributed to 51 FTP graduates. Quantitative data were analyzed using descriptive statistics. The authors analyzed narratives using Burke's dramatistic pentad as a qualitative framework to delineate how interrelated themes interacted in the FTP. RESULTS: Forty-seven respondents (92%) identified two essential acts that happened in the program: an iterative learning process, leading to heightened personal awareness and group facilitation skills; and longevity of learning and effect on career. The structure of the program's learning community provided the scene, and the agents were the participants, who provided support and contributed to mutual success. Methods of developing skills in personal awareness, group facilitation, teaching, and feedback constituted agency. The purpose was to learn skills and to join a community to share common values. CONCLUSIONS: The FTP is a learning community that provided faculty with skills in principles of relationship-centered care. Four further features that describe elements of this successful faculty-based learning community are achievement of self-identified goals, distance learning modalities, opportunities to safely discuss workplace issues outside the workplace, and self-renewing membership.

Direct observation of faculty with feedback: an effective means of improving patient-centered and learner-centered teaching skills.

BACKGROUND: In 2002 Lehigh Valley Hospital and Health Network Internal Medicine residency program sought to establish a faculty development program for their teaching faculty that emphasized learner-centered teaching of patient-centered care. DESCRIPTION: Medical educators trained in observational research practices shadowed teaching teams for 24 months and observed 24 General Internal Medicine faculty teach on inpatient rounds and provided timely written feedback to faculty. Within 48 hr, faculty received a completed Observation Feedback Sheet and summary comments. EVALUATION: Teaching skills were seen to improve over time after feedback was provided and repeat observations occurred. Observation ratings mirrored the results of the established Department of Medicine resident ranking of faculty teaching: Observed faculty receiving feedback improved their ranking, whereas faculty not observed did not. CONCLUSIONS: Observation of teaching with written feedback is an effective means of individualizing faculty development and improving learner-centered and microskill teaching of patient-centered care.