{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T13:34:37Z","timestamp":1790775277890,"version":"4.1.0"},"reference-count":66,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2020,2,20]],"date-time":"2020-02-20T00:00:00Z","timestamp":1582156800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Palliative Medicine"],"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Failure to initiate discussions about patients' values and goals in serious illness remains a common problem. Many clinicians are inadequately trained for these discussions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>Evaluate whether a novel train-the-trainer model results in high-quality training that improves clinicians' self-reported competencies in serious illness communication.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Multimethod evaluation of an educational program.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting\/Context:<\/jats:title>\n                    <jats:p>In 2016, three faculty at Ariadne Labs (AL) conducted three train-the-trainer courses to equip faculty trainers at each of the three institutions to teach serious illness communication to clinicians.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measures:<\/jats:title>\n                    <jats:p>As collected by a post-training questionnaire, primary evaluation measure is clinicians' self-reported change in skills after the training compared with before. Secondary measures include a course evaluation and qualitative learnings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      From 2016 to 2018, AL trained 22 trainers (19\/22 were palliative care specialists) in three systems, who trained 297 clinicians (49% physicians; 35% advanced practice clinicians; 12% registered nurses, social workers, or chaplain; 4.0% Other) spanning subspecialties (48%); primary care (28%); palliative care (17%); and other (7.1%). Clinicians reported statistically significant improvement in all skills for two of the systems, with a third system demonstrating improvement in all skills with two reaching statistical significance (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.0001). Participants rated the quality of the training highly (95% mostly\/extremely effective) and shared a diverse array of takeaways that reflect positive shifts in knowledge, attitudes, and skills.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Serious illness communication training, delivered through a train-the-trainer model, was highly acceptable and resulted in significant self-reported improvements in competencies of clinicians. This may be a viable method for health systems seeking to train their clinical workforce.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/jpm.2019.0334","type":"journal-article","created":{"date-parts":[[2019,9,10]],"date-time":"2019-09-10T12:10:27Z","timestamp":1568117427000},"page":"337-345","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":68,"title":["Training Clinicians in Serious Illness Communication Using a Structured Guide: Evaluation of a Training Program in Three Health Systems"],"prefix":"10.1177","volume":"23","author":[{"given":"Joanna","family":"Paladino","sequence":"first","affiliation":[{"name":"Ariadne Labs, Brigham and Women's Hospital, Harvard TH Chan School of Public Health, Boston, Massachusetts."},{"name":"Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurel","family":"Kilpatrick","sequence":"additional","affiliation":[{"name":"Baylor Scott &amp; White Health, Texas A&amp;M University College of Medicine, Bryan, Texas."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nina","family":"O'Connor","sequence":"additional","affiliation":[{"name":"Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramya","family":"Prabhakar","sequence":"additional","affiliation":[{"name":"Lowell General Hospital, Lowell, Massachusetts."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Kennedy","sequence":"additional","affiliation":[{"name":"Ariadne Labs, Brigham and Women's Hospital, Harvard TH Chan School of Public Health, Boston, Massachusetts."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brandon J.","family":"Neal","sequence":"additional","affiliation":[{"name":"Ariadne Labs, Brigham and Women's Hospital, Harvard TH Chan School of Public Health, Boston, Massachusetts."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"Kavanagh","sequence":"additional","affiliation":[{"name":"Ariadne Labs, Brigham and Women's Hospital, Harvard TH Chan School of Public Health, Boston, Massachusetts."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin","family":"Sanders","sequence":"additional","affiliation":[{"name":"Ariadne Labs, Brigham and Women's Hospital, Harvard TH Chan School of Public Health, Boston, Massachusetts."},{"name":"Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Block","sequence":"additional","affiliation":[{"name":"Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts."},{"name":"Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts."},{"name":"Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik","family":"Fromme","sequence":"additional","affiliation":[{"name":"Ariadne Labs, Brigham and Women's Hospital, Harvard TH Chan School of Public Health, Boston, Massachusetts."},{"name":"Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2020,2,20]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.7326\/M13-1609"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2012.207624"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.18604"},{"key":"e_1_3_4_5_2","unstructured":"Committee on Approaching Death. 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