Video-based communication research and training in decision-making in supportive and palliative care (VERDIS) Insight 2013

This project aims to improve knowledge on the conceptual underpinning of shared decision making. By looking in depth at verbal and nonverbal communication, this research will help to move the field forward by providing methods to help care providers understand the “how” of shared decision making.

We are working with the Sue Ryder Care Centre for the Study of Supportive, Palliative and End of Life Care at the University of Nottingham who will harness the potential of video-based research by characterising verbal and non-verbal practices and patterns within decision-making involving experienced clinicians.  The work will be based in an end of life care setting.

The project will produce detailed knowledge about communication practices and strategies that provide opportunities for shared decision-making between patients and their significant others and experienced hospice consultants; and constitute the implementation of shared decision making with patients and significant others who show some preference for this form of decision making. This knowledge will be used to extend good practice guidance; design staff training materials; and prepare for large-scale evaluation of the effects of video-supported training.

The premises and theories underlying the VERDIS research project include the following:

• The content and style of face-to-face communication significantly affect the quality of decision-making interactions, and the provision of opportunities for patients and their significant others to participate in shared decision-making
• Current recommendations that propose ways of communicating to promote shared decision-making rely on limited evidence, little of it from direct observations
• Communication training in shared decision-making has shown limited effects 
• Communication training’s effectiveness is maximised when it is based on detailed empirical, observational evidence about communication practices and their effects in real life contexts
• New observational evidence about verbal and non-verbal communication during real life consultations will result in better, more nuanced guidance, and in training  that is more likely to show effects on consultation behaviours and patient’s experiences

The VERDIS team have been provided with an award to carry out some additional work on communication skills for diagnosing, supporting and treating patients who have long-term and terminal illnesses and who are in pain. The end date for this supplementary work will be May 2017.

Contact details

For more information about this project, please contact Liz Cairncross, Research Manager at the Health Foundation.