A systematic review of end of life care communication skills training for generalist palliative care providers: research quality and reporting guidance.

CONTEXT: End of life care (EoLC) communication skills training for generalist palliative care providers is recommended in policy guidance globally. Whilst many training programmes now exist, there has been no comprehensive evidence synthesis to inform future training delivery and evaluation. OBJECTIVES: To identify and appraise how EoLC communication skills training interventions for generalist palliative care providers are developed, delivered, evaluated, and reported. METHODS: Systematic review. Ten electronic databases (inception to December 2015) and five relevant journals (January 2004 to December 2015) were searched. Studies testing the effectiveness of EoLC communication skills training for generalists were included. Two independent authors assessed study quality. Descriptive statistics and narrative synthesis are used to summarise the findings. RESULTS: From 11,441 unique records, 170 reports were identified (157 published, 13 unpublished), representing 160 evaluation studies of 153 training interventions. Of published papers, eight were low quality, 108 medium, and 41 high. Few interventions were developed with service user involvement (n=7), and most were taught using a mixture of didactics (n=123), reflection and discussion (n=105), and roleplay (n=86). Evaluation designs were weak: <30% were controlled, <15% randomised participants. Over half (n=85) relied on staff self-reported outcomes to assess effectiveness, and 49% did not cite psychometrically validated measures. Key information (e.g. training duration, participant flow) was poorly reported. CONCLUSIONS: Despite a proliferation of EoLC communication skills training interventions in the literature, evidence is limited by poor reporting and weak methodology. Based on our findings we present a CONSORT statement supplement to improve future reporting and encourage more rigorous testing. REGISTRATION NUMBER: CRD42014014777.