Table 2.
Themes and Sample Comments.
| Data Generating Question Theme | Sample Comment |
|---|---|
| Theme 1: Benefits of training as a means to learn | |
| • Information and demonstration of communication skills by a PC/EOL expert were helpful | “Information was useful. Data presentation and observing consultant interviewing parents were helpful.” (MD #1) |
| • Helpful communication strategies (i.e., hope and non-abandonment messages) to deliver the protocol | “… very helpful reviewing communication responses to open the lines of communication. Helpful that hope and non-abandonment was emphasized.” (MD #2) |
| • Emphasis on the importance of assessing parents’ goals | “Goal directed care planning … meaningful to our practice.” (MD #3) |
| Theme 2: Benefits of expert mentor and practice skills | |
| • PC/EOL communication content, provided by a trusted PC communication expert | “… very useful to have the opportunity to listen and observe spoken and unspoken language [during role plays].” (RN #1) |
| • An opportunity to practice and refine communication skills delivered to families | “… very helpful to incorporate what we heard or observed into our language of the interview process. The skills practice was very helpful. Reflections after role play excellent for learning.” (RN #2) |
| Theme 3: Meaningful PC/EOL tools to use after training | |
| • Gaining new communication tools and opportunity to apply skills with team members | “Information shared regarding hope, anticipatory guidance, therapeutic alliance will stay with my practice forever. I have gained tools that are invaluable.” (MD #4) |
| • Recognizing previous PC/EOL communication training was inadequate | “This opportunity [training for the study] has given me the piece of my career I have so longed for.” (RN #3) |
| “Helpful in learning new/better technique of communicating with each other as a team and with families.” (RN #4) | |
| • Participating in debriefing during and after role-playing activities | “Discussions during/after role-playing were helpful. And, the intent was to redirect/improve role-playing.” (RN #5) |
| Theme 4: Receptivity to implement the intervention in own practice | |
| • Planning to use the COMPLETE intervention in own practice | “This training gave me some insight & tools—i.e., language and approach to use for intro of palliative care. Not only are we learning with our families [in the study]. I will have the opportunity to also teach other co-workers.” (RN #7) |
| • Recognition of how communication tools can be used to initiate PC/EOL discussions | “The slide of communication responses will be very helpful to open the lines of communication.” (RN #8) |
| • Plans to use new skills to assess parents’ goals and integrate with child’s plan of care | “Gives me starting points for conversations with parents/patients. It will be useful in my clinic visits with families in my conversations. I can further pinpoint their goals and try to align what we are doing with their goals.” (RN #6) |
| Theme 5: Recommendations for future training | |
| • Expand training time | “Definitely needed 2 days. This was intense, one day is inappropriate.” (RN #4) |
| • Modify role-playing scenarios to be more clinically focused | “Change scenarios to include baseline MRIs with stable results.” (RN #6) |
| • Develop strategies to implement in a busy clinic | “Perhaps add content as to how this may be implemented in a timely manner in a real busy practice.” (MD #5) |
Abbreviations: COMPLETE, Communication Plan: Early through End of Life; MD, physician; PC/EOL, palliative and end-of-life care; RN, nurse.