Table 1

Goals of the Serious Illness Care Training Program

By the end of the programme, learners will be able to demonstrate
GoalOutcome
1. Communication skills
 Use of silence, facilitating patient talk▸ Allows silence before responding when patient is taking in information or expressing emotion
▸ Patient speaks >50% of time
 Acknowledging and responding to patient/family emotion▸ Acknowledges difficult emotions during discussion
▸ Responds to emotion with empathic comment or further exploration
▸ Avoids using information or premature reassurance to respond to emotion
 Eliciting patient concerns▸ Encourages patient to express fears, worries, other concerns
 Assessing patient receptivity▸ Accurately assesses patient's receptivity to receiving new information and considering other options for treatment
 Recognising appropriate time for exploration and for making a recommendation▸ Initiates conversation early in the course of illness, and when prompted by disease progression or other clinical changes
▸ Makes a recommendation based on an accurate assessment of patient receptivity
 Identifying key challenging scenarios in using the SICG, and strategies for addressing them▸ Describes concrete strategies for dealing with crying, anger, denial, and avoidance
 Use of follow-up questions to further explore unclear or limited patient responses▸ Asks follow-up questions when patient does not provide a full or complete answer to SICG question
2. Mastery of SICG
 Effective use of SICG▸ Clinician completes all elements of SICG
 Shares prognosis (as desired by patient)▸ Gives prognosis in a range (days to weeks, weeks to months, etc), with acknowledgement of uncertainty
 Documentation in ACP module▸ Documents critical information for colleagues in ACP module
  • ACP, advance care planning; SICG, Serious Illness Conversation Guide.