Table 3.
Open-ended Responses to Evaluation Questions
| Planned Changes to Practice and Lessons Learned | ||
|---|---|---|
| Theme | Subtheme | Example quotes |
| Present AMCWD among kidney failure treatment options | Balanced presentation about AMCWD vs dialysis | Incorporate more discussion and data around the survival benefits of HD vs AMCWD (Nurse) |
| I have always counseled patients on supportive care however I have more information…about how it impacts patients. Possible 14 months of life survival and a lower hospitalization rate (Advanced Practice Nurse) | ||
| Helping the patient make their choices by offering all options without feeling uncomfortable doing so (Advanced Practice Nurse) | ||
| Apply communication skills | Use Ask-Tell-Ask | Use more Ask-Tell-Ask approach rather than entering visit with my own agenda (Physician Assistant) |
| Use Ask-Tell-Ask open-ended questions (Renal Care Coordinator) | ||
| Use silence and active listening | I will try to allow patients more time to speak even if I have to find a different area in the office so this may happen (Nurse) | |
| Provide areas of silence to allow patient to absorb, think and speak (Nurse) | ||
| Allowing more silence and allowing the patient to guide the conversation (RN, soon to be APN) | ||
| Empathy and responding to emotion | Not use the phrase “I understand” but use reflective language (Nephrologist) | |
| More actively reflecting patient emotions (Physician Assistant) | ||
| Take time | Allow more time to build trustworthy relationships and discussions (Renal Care Coordinator) | |
| Allow more time for patients to be able to express feelings and not feel that they are rushed (Nurse) | ||
| Incorporate ExPAND tools | Incorporate the tools in the class, like printing the 9 values, emotion wheel, and be more aware of biases (Social Worker) | |
| Reinforced current practice | Knowing evidence base information reinforced my practice (Nephrology) | |
| Reiterated what I am doing well and alter key points in my conservative care talk (Physician Assistant) | ||
| Provided reassurance that current techniques are successful (Advanced Practice Nurse) | ||
Abbreviations: APN, Advanced practice nurse; AMCWD, active medical care without dialysis; HD, hemodialysis; RN, registered nurse.