The Second Conversation Model
Research type
Research Study
Full title
The Second Conversation Model: A qualitative study to evaluate the benefits and potential risks of a communication skills training tool for junior doctors from the perspectives of clinicians, patients and informal caregivers.
IRAS ID
236652
Contact name
Katherine Sleeman
Contact email
Sponsor organisation
King's College London
Duration of Study in the UK
1 years, 0 months, 1 days
Research summary
Advance care planning, personalised to patients’ needs and priorities, is the cornerstone of good end of life care. However, inadequate clinician communication skills can lead to the failure of end of life care planning and is often the focus of NHS complaints. Reports such as the Neuberger and Francis reviews demonstrate the devastating effect that poor communication can have on patients and families.
All junior doctors, irrespective of their specialty, will care for patients who die, but can be reluctant to initiate these discussions due to low confidence in their communication skills, feeling under-prepared or fearful of causing distress. Improving junior doctors’ skills in end of life communication would help ensure patients’ preferences and priorities are met, while improving satisfaction for doctors.
The Second Conversation Model is an on-the-job training to improve junior doctors’ skills in having these discussions with patients and their informal caregivers. The three-stage process is based on good clinical practice: (i) observation by a junior doctor of an initial senior-led conversation followed by debrief, and preparation for; (ii) the second conversation which occurs soon afterwards, and is led by the junior doctor; (iii) subsequent facilitated reflection and feedback with senior colleague. Feasibility was tested in a 2017 pilot, which demonstrated positive attitudes among participants and supervisors.
This study will take place at two NHS hospital sites over six months. It aims to evaluate the benefits and potential risks of the Second Conversation Model through qualitative in-depth interviews with junior doctors, senior doctors, patients and/or their informal caregivers. The study is funded through a Royal Marsden Partners one year clinical research fellowship and will be recruiting at the Royal Free Hospital and St Thomas’ Hospital.
REC name
London - Camberwell St Giles Research Ethics Committee
REC reference
18/LO/0011
Date of REC Opinion
14 Feb 2018
REC opinion
Further Information Favourable Opinion