Realtalk Evidence-Based Communication Training: Development of a Conversation Analysis-Based Intervention Designed to be Delivered by Clinical Trainers

BACKGROUNDCommunication skills training for professionals caring for people with life-limiting conditions is in demand. Evidence shows that transfer of skills into practice is limited. Training can be improved by building on in-depth evidence and reflecting the complexity of actual interactions. Scientific advances from direct observational ‘conversation analytic’ studies of conversations in healthcare and beyond provide this evidence, but the linguistic complexities are often inaccessible to clinical trainers. We address this dilemma via a novel training initiative, ‘RealTalk’, designed to support trainers by increasing the authenticity and evidence base of end-of-life communication training for health and social care staff and trainees.METHODSWe conducted a development study to create a communication intervention for testing. In collaboration with stakeholders, we identified the rationale for the content and mode of delivery, converted research findings into an applied intervention, and tested and refined the intervention prior to launching the finished product. RESULTSUsing a conversation analytic approach, we made and analysed video recordings of real-life palliative care consultations in a large UK hospice. We transformed our findings into preliminary training resources comprising clips from the video recordings and accompanying written materials. We shared the materials with an advisory group of clinicians, educators and researchers. Based on feedback, we modified the materials. Trainers in UK higher education institutions, healthcare organisations and independent hospices piloted our materials within their own training and fed back. Further modifications followed in readiness for evaluation of acceptability, usability and effects on practice. The first version of RealTalk comprised two training modules, on ‘Broaching Dying’ and ‘Life Expectancy Enquiries’. Each module includes video clips from several patient cases, alongside written transcripts, case synopses and evidence-based learning points. CONCLUSIONSThe authentic and evidence-based RealTalk resources support experiential and reflective learning, focused on a range of communication problems and practices, for trainees from a wide range of backgrounds. Our process for developing RealTalk can serve as a prototype for developing other communication training resources based on data and findings from observational research on (recordings of) real-life interpersonal interactions.