Course Image Communication Part IV

Communication Part IV

Part 4: Developing communication skills

ACE
Ethics

Summary

The gap between the importance of communication skills in critical care and the lack of structured educational programs to improve critical care clinicians’ comfort and skill in these areas is a reality that must be recognized.




General Information

Enrolled trainees 674

Open 03.06.2019

Available for ESICM members

Student effort 1

Last Updated March 20, 2024

Intended Learning Outcomes

At the end of this course you should be able to:  

  • Describe effective communication strategies with patients
  • Discuss the adaptation of these strategies for team communication enhancement

Relevant competencies in CoBaTrICE

  • 12.1 Professionalism/communication skills: Communicates effectively with patients and relatives  
  • 12.2 Professionalism/Communication skills: Communicates effectively with members of the health care team

Enrollment Options

You are currently NOT enrolled in this course.

This course is available only for registered ESICM members.

If you are an ESICM member you can enrol yourself by clicking the Enrol Me button.

If there is no Enrol button on the top left of this card please check that you have login and that you are an ESICM Member.

Verify that you are logged in the Academy using your valid ESICM account to enrol yourself in the course.

Disclaimer

All authors of ACE courses sign a document declaring absence or any actual or potential conflicts of interest. In addition, they sign a copyright document confirming the work is their own and that they have obtained the necessary permission for any copyrighted material. The latter document also transfers the intellectual copyright to the ESICM. Both the conflict of interest and copyright forms are filed and stored in compliance with GDPR and are available for inspection upon request.

Course Image Communication Part III

Communication Part III

Part 3: Communicating with co-workers

ACE
Ethics

Summary

Research in healthcare shows that patients frequently experience unnecessary harm as a result of preventable medical errors. These events can result in the substantial suffering of patients, as well as a high financial burden in terms of extended hospital stays and litigation costs. In the intensive care unit (ICU), the complex and multidisciplinary nature of intensive care medicine renders it particularly susceptible to the occurrence of medical errors. 




General Information

Enrolled trainees 724

Open 03.06.2019

Available for ESICM members

Student effort 1

Last Updated March 20, 2024

Intended Learning Outcomes

After studying this module on Communicating with co-workers, you should be able to:

  • Describe how to deliver a clear, succinct and adequate handover
  • Describe the open communication of errors in the ICU
  • Discuss the advantages and barriers to good team-work

Relevant competencies in CoBaTrICE

  • 12.2 Professionalism: Communicates effectively with members of the health care team 
  • 12.7 Professionalism: Collaborates and consults; promotes team-working   
  • 12.8 Professionalism: Ensures continuity of care through effective hand-over of clinical information  
  • 12.9 Professionalism: Supports clinical staff outside the ICU to enable the delivery of effective care  
  • 12.10 Professionalism: Appropriately supervises, and delegates to others, the delivery of patient care  

Enrollment Options

You are currently NOT enrolled in this course.

This course is available only for registered ESICM members.

If you are an ESICM member you can enrol yourself by clicking the Enrol Me button.

If there is no Enrol button on the top left of this card please check that you have login and that you are an ESICM Member.

Verify that you are logged in the Academy using your valid ESICM account to enrol yourself in the course.

Disclaimer

All authors of ACE courses sign a document declaring absence or any actual or potential conflicts of interest. In addition, they sign a copyright document confirming the work is their own and that they have obtained the necessary permission for any copyrighted material. The latter document also transfers the intellectual copyright to the ESICM. Both the conflict of interest and copyright forms are filed and stored in compliance with GDPR and are available for inspection upon request.

Course Image Communication Part II

Communication Part II

Part 2: Communicating with Families

ACE
Ethics

Summary

Family centered communication involves establishing a positive relationship with family members, mutual information exchange between family and staff, responding to family emotions, managing uncertainty and making shared decisions.  One particularly daunting  type of communication faced by physicians is delivering bad news. For many, their first experience involves patients they have known only a few hours. Additionally, they are called upon to deliver the news with little planning or training, which often leads to misunderstandings and conflict. Poor communication increases the risk of adverse psychological outcomes such as anxiety, acute stress disorder, posttraumatic stress for families. 

Historically, medical education has placed more value on technical proficiency than communication skills. This leaves physicians unprepared for the communication complexity and emotional intensity of breaking bad news. The fears doctors have about delivering bad news include being blamed, evoking a reaction, expressing emotion, not knowing all the answers, fear of the unknown and untaught, and personal fear of illness and death. This can lead physicians to become emotionally disengaged from their patients. Additionally, bad news delivered inadequately or insensitively can impair patients' and relatives' long-term adjustments to the consequences of that news.

In this course we will explore some strategies to communicate with patients and address the issue of how to “break bad news” in intensive care.




General Information

Enrolled trainees 786

Open 03.06.2019

Available for ESICM members

Student effort 1

Last Updated March 20, 2024

Intended Learning Outcomes

After studying this module on Communicating with Families, you should be able to:

  • Discuss how to adequately provide information to family members
  • Discuss when and how to involve the family in decision-making and in patient care
  • Describe how to communicate bad news

Relevant competencies in CoBaTrICE

  • 12.1 Professionalism: Communicates effectively with patients and relatives 
  • 12.4 Professionalism: Involves patients (or their surrogates if applicable) in decisions about care and treatment  

Enrollment Options

You are currently NOT enrolled in this course.

This course is available only for registered ESICM members.

If you are an ESICM member you can enrol yourself by clicking the Enrol Me button.

If there is no Enrol button on the top left of this card please check that you have login and that you are an ESICM Member.

Verify that you are logged in the Academy using your valid ESICM account to enrol yourself in the course.

Disclaimer

All authors of ACE courses sign a document declaring absence or any actual or potential conflicts of interest. In addition, they sign a copyright document confirming the work is their own and that they have obtained the necessary permission for any copyrighted material. The latter document also transfers the intellectual copyright to the ESICM. Both the conflict of interest and copyright forms are filed and stored in compliance with GDPR and are available for inspection upon request.

Course Image Ethics

Ethics

ACE
Ethics

Summary

New medical and technological developments broaden the therapeutic armamentarium of the modern physician. At the same time, patients are often better informed than only a decade ago, and sometimes they pose unrealistic demands onto the health care teams and the health care system. Which treatments are at hand in a specific situation? And if at hand, do they need to be offered regardless of their possible benefits or costs? Or regardless of a patient’s wish?

Ethical dilemmas can and do arise in daily health care practice. Within medicine, critical care is an area where issues regarding autonomy, beneficence, possible harm and distributive justice commonly highlight ethical problems that the patients, their families and the critical care team need to deal with. The module “Ethics” does not attempt to provide answers to all the difficult questions, nor will it master all potential dilemmas, but it will point out some ways in which ethical issues in critical care can be addressed, clarified and hopefully solved.

Many critically care patients are too ill to discuss their goals of care or give their consent to treatment. It is often necessary to find a way to make difficult decisions, which may involve the initiation or the foregoing of intensive life-sustaining therapies, on a patient’s behalf. This module outlines approaches that respect the autonomy of the patient in reaching therapeutic decisions, for example with the help of surrogate decision makers, as well as the modern concept of shared-decision-making.

Intensive care technology has given practitioners the ability to sustain the body’s metabolic processes even when recovery to independent existence becomes impossible. Reasoning about potentially inappropriate treatment is an important ethical task. Where the line between doing good and causing unintended harm becomes very narrow, changing the goal of treatment from cure to comfort is often inevitable. The module discusses this often difficult process, including concepts such as “active shortening of the dying process” and “euthanasia” – which are frequently misunderstood and misused terms. The complexity and invasiveness of intensive care treatments may not only cause unintended harms to our patients; but together with poor working environments, may lead to medical errors and staff burnout. Problems that need to be addressed properly.

The rise in cultural diversity due to immigration is leading to new ethical dilemmas. The values of professionals, patients and families might not align, when they come from different backgrounds. In modern societies, it is no longer obvious that the views of the professionals are leading the way, yet medical care should not abandon its core ethical values.

Beyond the individual doctor-patient relationship, there is a valid public interest in the work physicians do. Some of the issues of public concern will be explored. Research involving critically ill patients poses an extra ethical challenge. The difficulties in obtaining consent, the often very small time windows in emergency research and the balance between potential benefit and harm is addressed in the final chapter of this module.




General Information

Enrolled trainees 1273

Open 11.06.2018

Available for ESICM members

Student effort 2

Last Updated April 4, 2022

Intended Learning Outcomes

After studying this module on Ethics, you should be able to:

  • Understanding ethical reasoning and ethical principles;
  • Understanding the principles of informed consent and surrogate decision-making;
  • Understanding the potential dilemma of cultural relativism;
  • Weighing risks and benefits of treatments, including potentially inappropriate treatments, and understanding the need for the change of treatment goals as well as for implementing end-of-life care and / or palliative care;
  • Handling medical errors;
  • Understanding and applying the principles of shared decision-making;
  • Understanding the public interest in intensive care ethics, including the need for and the potential risks of research in that field.

Relevant competencies in CoBaTrICE

  • 8.1 Manages end of life care and the process of withdrawing and withholding treatment with the multidisciplinary team
  • 8.2 Discusses end of life care with patients and their families / surrogates
  • 8.3 Manages palliative care of the critically ill patient
  • 12.4 Involves patients (or their surrogates if applicable) in decisions about care and treatment
  • 12.5 Demonstrates respect of cultural and religious beliefs and an awareness of their impact on decision making
  • 12.12 Formulates clinical decisions with respect for ethical and legal principles

Enrollment Options

You are currently NOT enrolled in this course.

This course is available only for registered ESICM members.

If you are an ESICM member you can enrol yourself by clicking the Enrol Me button.

If there is no Enrol button on the top left of this card please check that you have login and that you are an ESICM Member.

Verify that you are logged in the Academy using your valid ESICM account to enrol yourself in the course.

Disclaimer

All authors of ACE courses sign a document declaring absence or any actual or potential conflicts of interest. In addition, they sign a copyright document confirming the work is their own and that they have obtained the necessary permission for any copyrighted material. The latter document also transfers the intellectual copyright to the ESICM. Both the conflict of interest and copyright forms are filed and stored in compliance with GDPR and are available for inspection upon request.

Course Image Communication Part I

Communication Part I

Part 1: Communicating with Patients

ACE
Ethics

Summary

‘What we’ve got here is... failure to communicate ...’ Strother Martin in the film Cool Hand Luke, 1967

The goal of communication is to convey information. Everyone communicates, but not all communication is successful. What is thought, may not be said. What is said may not be heard, what is heard may not be understood and what is understood may not be done.

There are many reasons for conveying information. Among them: to add to knowledge of a subject; to motivate someone to act; to exchange ideas; to express emotions. All these come into play in an intensive care unit (ICU). The ultimate goal of communication in the ICU is to improve patient outcomes and quality of care.




General Information

Enrolled trainees 971

Open 03.06.2019

Available for ESICM members

Student effort 1

Last Updated March 21, 2024

Intended Learning Outcomes

After studying this module on Communicating with Patients, you should be able to:

  • Describe an appropriate approach to communicating with the conscious and unsconscious patient
  • Discuss how to deal with communication barriers 
  • Describe the process of correctly obtaining informed consent from an ICU patient

Relevant competencies in CoBaTrICE

  • 7.1 Comfort and recovery: Identifies and attempts to minimise the physical and psychosocial consequences of critical illness for patients and families  
  • 12.1 Professionalism: Communicates effectively with patients and relatives 
  • 12.4 Professionalism: Involves patients (or their surrogates if applicable) in decisions about care and treatment  

Enrollment Options

You are currently NOT enrolled in this course.

This course is available only for registered ESICM members.

If you are an ESICM member you can enrol yourself by clicking the Enrol Me button.

If there is no Enrol button on the top left of this card please check that you have login and that you are an ESICM Member.

Verify that you are logged in the Academy using your valid ESICM account to enrol yourself in the course.

Disclaimer

All authors of ACE courses sign a document declaring absence or any actual or potential conflicts of interest. In addition, they sign a copyright document confirming the work is their own and that they have obtained the necessary permission for any copyrighted material. The latter document also transfers the intellectual copyright to the ESICM. Both the conflict of interest and copyright forms are filed and stored in compliance with GDPR and are available for inspection upon request.

Course Image Organ Donation and Transplantation

Organ Donation and Transplantation

ACE
Ethics

Summary

There were around 129.681 solid organ transplant procedures performed in 2020 worldwide (World Health Organization Global Observatory on Organ Donation and Transplantation), which represents a 17.6% decrease from 2019.

Intensive care plays a vital role in transplantation with regards to identifying potential donors, discussing organ donation with relatives, diagnosing brain death and circulatory death, and supporting potential organ donors until the transplantation occurs. 





General Information

Enrolled trainees 1302

Open 24.09.2019

Available for ESICM members

Student effort 1

Last Updated March 14, 2024

Intended Learning Outcomes

At the end of this course the student should be able to: 

  • Identify the two types of organ donation
  • List the conditions that have to be met for a patient to be considered for brainstem death testing
  • Describe the main pathophysiological changes occurring in the patient after brainstem death
  • State the tests for brainstem determination
  • Demonstrate knowledge of the physiological optimisation of the potential donor

Relevant competencies in CoBaTrICE

  • 8.4 Recognizes criteria of brain-death and performs medical investigations accordingly
  • 8.5 Manages the physiological support of the organ donor

Enrollment Options

You are currently NOT enrolled in this course.

This course is available only for registered ESICM members.

If you are an ESICM member you can enrol yourself by clicking the Enrol Me button.

If there is no Enrol button on the top left of this card please check that you have login and that you are an ESICM Member.

Verify that you are logged in the Academy using your valid ESICM account to enrol yourself in the course.

Disclaimer

All authors of ACE courses sign a document declaring absence or any actual or potential conflicts of interest. In addition, they sign a copyright document confirming the work is their own and that they have obtained the necessary permission for any copyrighted material. The latter document also transfers the intellectual copyright to the ESICM. Both the conflict of interest and copyright forms are filed and stored in compliance with GDPR and are available for inspection upon request.