Abstract
In our fast paced, data driven world where patients receive their lab results the moment their health care team does, clear and compassionate communication is key to providing meaningful care and building connections with patients. The second edition of Navigating Communication with Seriously Ill Patients provides the busy clinician with a simple and evidence-based framework for approaching the many communication challenges that may arise when caring for patients with serious illness.
Written by the co-founders and strategic partners of VitalTalk, a non-profit organization for teaching serious illness communication skills, this book offers evidence-based methods and insights from nearly two decades of experience teaching and using VitalTalk methodology.
The book can be divided into three sections. The first introduces core communication skills essential to all serious illness conversations, such as assessing perspective and responding to emotion. The second offers road maps for addressing specific communication topics clinicians are likely to encounter throughout the trajectory of serious illness, from sharing a new diagnosis to talking about dying, and everything in between. And the third provides tips for integrating new communication skills into practice.
While the book can certainly be read cover-to-cover, each chapter can also stand alone, allowing busy clinicians a quick refresher prior to entering a challenging communication encounter. Within each chapter, the authors solidify skills with cognitive roadmaps for specific communication challenges, explaining the rationale behind the skills and suggesting sample language. Additionally, they offer exemplar conversations to show the skills in action and to help the reader apply them to their own practice. Finally, the authors offer examples of how the skills can be applied to address common communication pitfalls and nuanced scenarios. In this way, the authors move from an abstract academic discussion to a practical skill-based demonstration.
The authors do not limit this text to a discussion of skills needed to communicate with patients and their families. Instead, they go on to discuss skills helpful in dealing with conflict between clinicians and patients, as well as among colleagues. These sections provide critical ideas in conflict management including how to recognize conflict, key questions we can ask ourselves to help navigate conflict, and how conflict with colleagues differs from conflict with patients. These sections help cultivate communication skills by encouraging readers to look internally and ask, how do we show up for people when things get hard?
In the final chapter of the book, the authors explicitly call out the need for deliberate practice to enact change and achieve mastery in communication. With roots in the science of learning, the authors suggest practice tools such as recording yourself, asking for feedback, deliberate note taking and, practicing one skill at a time followed by a debrief. This final section takes the brief exercises included at the end of each chapter and consolidates them. This practical guide reminds us that communication is a skill that can be taught and honed with deliberate practice. And, it encourages the reader to consider the learning habits that will set them up for success on the path of lifelong learning and mastery.
While this book is a great starting point for any clinician looking to expand their communication skills, there are notable areas that could benefit from further clarification or expansion. For example, it might be helpful to hear more about how to best explore values and address uncertainty in the context of decision making with serious illness. Both are complex topics that require further research. Another area for growth is how to best apply these skills to clinicians of various disciplines. The main audience for both the first and second edition of this book is clinical providers such as physicians and advance practice providers. While this book offers a universal starting point for clinicians of all disciplines to apply these skills to their role in patient care, it is equally important to address the challenging communication scenarios faced by all interprofessional team members including bedside nurses, social workers, and chaplains.
These experienced authors offer what is arguably the most comprehensive resource and training manual for skills in serious illness communication. What this book adds to existing resources is an unrelenting focus on the skills, the rationale behind why they work, and clear roadmaps that encourage deliberate practice over time. With this model, the authors have brought time-tested principles of adult learning theory to the reader’s fingertips. This book is an essential text for anyone caring for patients and families living with serious illness.
Conflict of Interest Statement
Drs. Ketterer, Chiarchiaro, and Stowers are VitalTalk faculty and receive compensation for teaching and curricula development.