College of Science, Technology & Applied Arts of Trinidad & Tobago

DEPARTMENT OF INFORMATION SCIENCE AND TECHNOLOGY

INDIVIDUAL ASSIGNMENT COVER PAGE

ASSIGNMENT TITLE: ARTICLE CRITIQUE

COURSE CODE: NURS 499

COURSE TITLE: SENIOR PROJECT NURSING

CRN: SEMESTER: II 2015-2016

STUDENT NAME: SHERRY KHAN

PROGRAMME: Bsc. General Nursing

ARTICLE CRITIQUE:

The article Effect of Communication Skills Training for Residents and Nurse

Practitioners on Quality of Communication With Patients With Serious Illness, by J.

Randall Curtis, MD, MPH1,2; Anthony L. Back, MD3; Dee W. Ford, MD, MSCR4;

Lois Downey, MA1; Sarah E. Shannon, PhD, RN2; Ardith Z. Doorenbos, PhD, RN2; Erin

K. Kross, MD1; Lynn F. Reinke, PhD, RN2,5; Laura C. Feemster, MD, MS1,5;

Barbara Edlund, PhD, ARNP6; Richard W. Arnold, MD7; Kim OConnor, MD7; Ruth

A. Engelberg, PhD1 seek to determine the effects of a communication skills intervention for

internal medicine and nurse practitioner trainees on patient and family reported outcomes. The

research problem being addressed is to improve quality of communication about end-of-life care

or quality of end-of-life care provided to patients.

TITLE:

The name of the journal article is Effect of Communication Skills Training for Residents

and Nurse Practitioners on Quality of Communication With Patients With Serious Illness. The

title was bolded black, in title case form, grammatically correct and is unambiguous. The

authors names were located directly under the title of the research paper and the date was seen

clearly at the top left hand corner of the page. According to Connell (1999), the heading should

be between 10 and 15 words long and should clearly identify the purpose of the study. Therefore,

this title was over the word limit. The title clearly states the group of individuals that is being

studied. In my opinion the title is clear, accurate and it clearly describes the purpose of the

article.
ABSTRACT:

The abstract is specifically clear and it concisely summarizes the key features of the

article such as the importance, objective, intervention and so on. It is stated that communication

about end-of-life care is a core clinical skill and the study was conducted to assess the effects of

a communication skills intervention for internal medicine and nurse practitioner trainees on

patient- and family-reported outcomes. Additionally, it was stated that a randomized trial was

conducted with 391 internal medicine and 81 nurse practitioner trainees where 232 participants

were randomized to an 8-session, simulation-based, communication skills intervention and 240

were provided with normal education. Questionnaires were also involved in the study process.

The abstract summarizes the outcome of the study. Therefore, a short description of the results

was given suggesting that simulation-based communication training compared with usual

education did not improve quality of communication about end-of-life care or the quality of end-

of-life care but was associated with a small increase in patients depressive symptoms.

In my opinion the abstract was sometimes difficult to understand with the abbreviations

and numbers. Otherwise it is well structured with specific headings; importance, objective,

method, conclusion and so on. The abstract captures the gist of the study; it provides the reader

with a summarised outcome of the study.

INTRODUCTION:

In the introduction the problem at hand is stated unambiguously and is easy to identify.

The statement of purpose was also identified which provides a rational as to why the research

was conducted and why it is necessary. The article has significance for all healthcare workers,
but as future nurses, this problem is of significance because the power of creative and effective

nursing care is strengthened by good communication skills. Patients share their stories,

symptoms, and concerns by talking with us. Both the spoken word and the body language

convey information about the patients experience. (Clinical communication. (n.d.)) The

significance of the problem and the need of the study were clearly stated by the authors. The

main purpose of the study examine whether a communication skillsbuilding workshop aimed at

internal medicine and nurse practitioner trainees, using simulation during which trainees

practiced skills associated with palliative and end-of-life care communication, had any effect on

patient-, family-, and clinician-reported outcomes. The purpose clearly stated what the

researchers wishes to achieve by undertaking this study.

METHOD

Human subjects approval were obtained from the University of Washington and Medical

University of South Carolina institutional review boards to conduct the study. Trainees provided

written consent before they commence to training. The study was designed in such a way to

minimize risk to the participants and to benefit both participants and the patients.

Sufficient amount of time was spent on field since the study was conducted from 2007 to

2013. Surveys were given out to the evaluators based on documented encounters between trainee

and evaluator. Encounters for the preintervention phase occurred in the 6-month period

preceding the workshop/control phase; encounters for the postintervention phase occurred in the

10 months following the workshop/control phase. The surveys did not reference a specific

encounter but asked evaluators to assess trainees across all encounters.

 Additionally, a summarized version of the outcome of the intervention is stated in the

methods as well as the statistical analyses which provides the reader with a concise information

on the outcome. This is stated in figures that are somewhat confusing, but majority of it I was

able to understand. The researchers described each group of participants that were involved in

the study in detail as well as sampling. The data was collected through questionnaires that was

developed through qualitative interviews with the necessary groups. Data collection and

recording procedures are adequately described. An additional analysis was conducted using

propensity scoring to weight patient scores on the primary outcome to examine for potential

nonresponse bias.

RESULTS:

The data that was obtained during the study was effectively summarized making it easy

for the reader to understand, it was invested in tables. In the results section the participants were

described based on gender, ethnicity and educational level. The research findings provided the

reader with an insight into the research and its outcome by providing diagrams and so on. The

authors chose to describe the data in percentage format, which could easily be understood. The

results table was helpful in visualizing the results. In my opinion, the results were organized into

each category of the findings, which made it easy to read and comprehend.

DISCUSSION:

According to the researchers there are no previous studies examining patient-reported

outcomes of such training. In addition, limitations ought to be considered because the

participation rates were fairly high for physicians but lower for nurse practitioners, participation
rates for evaluators could allow nonresponse bias and lastly evaluations were completed up to 10

months after the intervention, there could be shorter-term benefits that were not identified. It was

suggested in the discussion that future studies should explore the effect of discussing end-of-life

care on patients psychological symptoms and satisfaction with care.

CONCLUSION:

The conclusion was unambiguous and straight to the point. It highlights facts that

simulation-based communication skills training compared with usual education did not improve

quality of communication about end-of-life care or quality of end-of-life care but was associated

with a small increase in patients depressive symptoms. The outcome of this research raise

concerns to the authors about skills transfer from simulation training to actual patient care and

the adequacy of communication skills assessment.

TO CONCLUSION:

This assignment was very educational because it helped me to apply critical appraisal

skills. I am now better able to apply and analyze research articles. Nursing is an ever changing

process, and this assignment will help me to evaluate research articles, validity of the

information and to analyze the credibility of the findings. As a future nurse the power of creative

and effective nursing care is strengthened by good communication skills with patients, family

members as well as other members of the healthcare team. I must say that this assignment was a

bit of a challenge but nevertheless, completing this assignment was rewarding and informative.
 REFERENCE

Connell, M. (1999). The research critique. UCD Press. Retrieved 2015

Clinical communication. (n.d.). Retrieved March 03, 2016, from

http://nursing.flinders.edu.au/students/studyaids/clinicalcommunication/page.php?id=20

Curtis, J. R., Back, A. L., Ford, D. W., Downey, L., Shannon, S. E., Doorenbos, A. Z., . . .

Engelberg, R. A. (2013). Effect of Communication Skills Training for Residents and

Nurse Practitioners on Quality of Communication With Patients With Serious

Illness. Jama,310(21), 2271. Retrieved February 26, 2016, from

http://jama.jamanetwork.com/article.aspx?articleid=1787407&resultClick=24