All Providers Better Communication Skills Program' (ABCs)

Assessment of Clinical Encounter-Communications Tool (ACE-CT)

The Assessment of Clinical Encounter-Communications Tool (ACE-CT) is completed by external raters of the recorded simulated practices, on a 5-point scale (1 to 5), with higher scores representing a better outcome. The ACE-CT is comprised of 14 items that were developed by the research team through a rigorous mixed methods Bayesian and Delphi process. This scale was derived from an extensive review of existing validated tools to measure quality of communication, including Communication in Oncology Questionnaire \[Com-On\], Family Meeting Communication Assessment Tool \[FaMCAT\] Comskil Coding System (CCS), Serious Illness Conversation Evaluation Exercise \[SIC-Ex\], and Gap-Kalamazoo Communication Skills Assessment Form. Item selection was based on the evidence of elements of HCP communication that are of high importance to patients and families and in which there are gaps in current experiences and practices.

Self-Efficacy Questionnaire (SE-12)

Completed by participants, the Self-Efficacy Questionnaire (SE-12) is a 12 item survey developed to measure the impact of communication skills training from the perspective of the participants. The SE-12 uses a 10-point scale (1 to 10), with higher scores representing a better outcome. This questionnaire has been validated and widely used in different settings, with different types of HCPs. The SE-12 has demonstrated internal consistency (Cronbach's α = 0.95) and response stability in test-retest reliability (Intraclass correlation agreement of 0.71). Scores were found to highly correlate with experience in clinical communication (P = 0.02).

End-of-life Professional Caregiver Survey (EPCS)

Completed by participants, the End-of-life Professional Caregiver Survey (EPCS) is a 28-item scale developed to assess palliative care-specific educational needs related to three main subdomains: Effective Care Delivery (ECD 8-items); Patient and Family-Centered Communication (PFCC 12-items); and Cultural and Ethical Values (CEV 8-items). For the purposes of this study, the investigators will only include the Patient and Family-Centered Communication (PFCC) sub-domain. Each item is scored on a 5-point Likert scale ranging from 1 (lowest level of skill) to 5 (greatest level of skill), with higher scores representing a better outcome. Items represent care-provider comfort with a variety of situations related to palliative and EOL care. The EPCS covers all eight domains of the national palliative care guidelines and core lessons of physician-specific and nurse-specific end of life education curricula in the USA. The EPCS exhibits strong internal consistency (alpha = 0.96).

Blended Learning Usability Evaluation - Questionnaire (BLUE-Q)

Completed by participants, the Blended Learning Usability Evaluation - Questionnaire (BLUE-Q) is a 31 item, three-part questionnaire that was developed and validated by members of this research team. The purpose of the BLUE-Q is to: evaluate the usability of blended learning programs, specifically those deployed across medical and health sciences education; systematize program evaluations for these interventions; and facilitate rigorous comparison between these different interventions. The BLUE-Q has a total of 23 Likert scale items (5-point scale, 1="Strongly Disagree" to 5="Strongly Agree", higher scores representing a better outcome) and 6 open-ended questions. The three parts of the BLUE-Q are: 1) pedagogical usability (i.e., the program content, learning objectives, and experience of learners with their instructors); 2) synchronous learning aspects; and 3) asynchronous learning aspects.

Qualitative Interviews

In-depth interviews will be conducted via Zoom video communications application with select participants (15 to 25) in the ABCs, following completion of the intervention. This qualitative data collection will provide additional information on participant experience with the ABCs education program, applicability to practice, and learning context.