Re-ACT: Remote Advanced Communication Training in a Time of Crisis

Abstract

Background: We used a quality improvement framework to transform two-day and in-person advanced communication training (ACT) course into a remote ACT (Re-ACT) format to help clinicians improve serious illness conversation (SIC) skills.

Measures: We assessed the reach, impact, and costs of Re-ACT and compared these measures to in-person ACT courses.

Interventions: About 45-60 minutes of synchronous, remote sessions consisting of a didactic introduction to SIC skills, tailored to the SARS-Cov-2 (COVID-19) crisis, and a live demonstration of SICs with patient-actors.

Outcomes: The transition to Re-ACT sessions resulted in reaching a greater number of clinicians in less time, although depth of content and opportunities for skill practice decreased. Although both formats were well received, Re-ACT respondents felt less prepared than ACT respondents to use SIC skills. The costs of Re-ACT were significantly less than in-person ACT courses.

Conclusions/lessons learned: We provided effective and well-received SIC training during a time of crisis. Future work should further define the optimal mix of in-person and remote experiences to teach SIC skills.

Keywords: COVID-19; Communication training; cost effectiveness; distance learning; quality improvement; resource limitations.