Abstract Rationale Effective goals of care conversations for seriously ill hospitalized patients improve outcomes for patients, families, and health systems. However, many clinicians lack the complex communication skills required, largely due to the absence of low-cost, scalable, evidence-based training programs. Objective To develop and user-test Critical Conversations, a scalable, technology-enhanced training program designed to improve clinicians’ serious illness communication skills. Methods We employed a user-centered co-creation process to design the platform and training program. This included: (1) iterative engagement with a stakeholder panel, (2) developing a prototype and beta version of the platform and training, and (3) two rounds of user testing with hospital-based physicians and advanced practice providers (APPs). We assessed usability using the System Usability Scale (SUS). We assessed acceptability and perceived effectiveness via internally developed questionnaires with quantitative ratings and qualitative feedback. Results Over 14 months, fifteen stakeholders (hospital-based physicians and APPs from a Pennsylvania health system) identified key design priorities for the platform: intuitive navigation for learners and coaches, a video upload interface for skill practice and feedback, and accessible video content with captions and transcripts. Training program priorities included a simple and memorable framework for learning the skills (i.e., Vital Talk’s REMAP framework), multimodal delivery (e.g., text, brief videos, audio), expert modeling, opportunities for practice, and value-added content. The resulting platform, Communication Catalyst, integrates these features and supports interactive elements such as video demonstrations, personalized feedback, quizzes, and progress tracking. Within this platform, The Critical Conversations course includes 3 hours of content completed over 3 weeks, grounded in the I-REMAP framework. Each week, participants complete two self-paced lessons (≤30 minutes each) and a 90-minute virtual synchronous skills practice session with peers and a trained coach. Ten clinicians participated in user testing, accessing content on desktop and mobile devices; three completed a mock coaching session. Participants rated the program as having excellent usability (mean SUS score 87.3/100 ± 9.4], high acceptability (mean: 4.6/5 ± 0.5), and strong perceived effectiveness (mean: 4.8/5 ± 0.4). Qualitative feedback highlighted the clarity of the I-REMAP framework, the value of expert modeling, and the benefit of low-stakes practice with feedback during coaching sessions. Conclusions Using a user-centered co-creation process, we developed a scalable, technology-enhanced training program to improve clinicians’ skills in serious illness communication. Participants’ high ratings of usability, acceptability, and effectiveness support advancing to a pilot study to assess the feasibility and efficacy of the Critical Conversations training program. This abstract is funded by: NIA R01AG068567-S1
Butler et al. (Fri,) studied this question.