MVP-medical situation, values, and plan : a memorable and useful model for all serious illness conversations

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HOROWITZ, Robert K. | HOGAN, Laura A. | CARROLL, Thomas

Serious illness conversations (SICs) are integral to the optimal care of the vast and growing population of seriously ill patients, but they are undertaught in health professions training and widely feared, delayed, or altogether avoided by clinicians. To redress this predicament, medical communication experts have published a variety of communication models designed to aid and promote SIC facilitation. We three clinician-educators are among their many beneficiaries. Yet despite their value, our experience in communication education and clinical encounters has revealed three recurring impediments to their instruction, retention, and usefulness. Although to our knowledge they have not been empirically evaluated, these pedagogic and practical weaknesses are potentially explained by both learning theory and mnemonics scholarship: 1) learning different communication models for different types of SICs demands multiple rounds of information recoding and consolidation into long-term memory, which may overwhelm learners' cognitive load capacity; 2) ostensibly sequential mnemonics (e.g., acronyms) that incorporate nonsequential components may burden working memory, compromise incorporation into long-term memory, and if recalled, muddle the very communication process they are designed to simplify; and 3) content that is selected to conform to a memorable mnemonic, rather than vice versa, may strain the language, increase the number and complexity of elements to be encoded and decoded, and thereby challenge retention and recall.

http://dx.doi.org/10.1016/j.jpainsymman.2020.07.022

Voir la revue «JOURNAL OF PAIN AND SYMPTOM MANAGEMENT, 60»

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