Building knowledge and capabilities: Grounding new developments of RealTalk on user evaluation

Background to RealTalk

RealTalk is an established enterprise project translating evidence from conversation analytic research on healthcare interactions in palliative and end-of-life care. Its overarching purpose is to translate new insights and evidence from conversation science into real-life healthcare training and practice. The guidance embodied in RealTalk is grounded in published evidence from an ongoing research programme, which commenced in 2013.

The RealTalk resources comprise a set of online evidence-based communication skills training resources for healthcare practitioners. These are centred around a set of real-life video and audio recordings of consultations in palliative care, end-of-life care, and bereavement services, and are accompanied by pedagogic guidance for use in training with healthcare practitioners.

The resources are hosted on a website (www.realtalktraining.co.uk) where they are available to registered users – educators who provide healthcare and social care skills training in the NHS, Higher Education Institutions, independent hospices, and other third-sector organisations.

Operational management of RealTalk transferred from Loughborough University to Treetops Hospice (a provider of palliative care and training for healthcare practitioners) in September 2022. At the time of writing, there are 440 registered users of RealTalk, comprising practitioners working within the following sectors:

• NHS: n=229 (51%)

NHS Hospital/NHS Trust: n=208 (47%)

NHS Hospice: n=6 (1%)

NHS ‘other’: n=15 (3%)

• Third sector: n=160 (37%)

Independent hospice: n=131 (30%)

‘Other’ third sector: n=29 (7%)

• Higher education institution (HEI): n=42 (10%)

• Independent sector/‘other’: n=9 (2%)

It is important to note that the Treetops Hospice team (Treetops henceforth) deliver more that the operational management of RealTalk as set out in the license agreement with Loughborough University (LU). Treetops collaborate with LU in improving the design and content of the training resources; they provide user support; they work to further disseminate RealTalk through various activities, including social media, newsletters, conference presentations, and presentations about RealTalk at several professional events. Treetops additionally support users through introductory workshops to the use of RealTalk. They use RealTalk in the delivery of tier-2 and tier-3 communication skills training workshops for healthcare professionals.

Evaluation design

Aims

The aims of the project were to:

• Carry out a comprehensive evaluation of user perspectives on the design, content, and current delivery of RealTalk training, including strengths, limitations, and any areas of unmet need.

• Use the findings to inform action plans for the future development and expansion of RealTalk, ensuring that its design, content and delivery are fully aligned with user experiences, requirements and values.

And, ultimately, to:

• Ensure the future viability of RealTalk and enhance its long-term sustainability.

• Increase the uptake of RealTalk, extending its benefits to greater numbers of patients and healthcare professionals engaged in important conversations around end-of-life care.

Methods

The perspectives of two groups of users were gathered:

a) Trainers (i.e. direct users of RealTalk): Communication skills trainers who use the resources within the training events they deliver.

b) Trainees (i.e. end users of RealTalk): Health and social care practitioners who are trained by the above trainers.

A mixed-methods approach was adopted, with data collected via the following methods:

1. Online cross-sectional survey with a sample of trainers. (See Section 1).

2. Online longitudinal survey of a sample of trainees, tracking their experiences before and after training, and at six-month follow-up. (See Section 2).

3. Supplementary data from a concurrent longitudinal survey of trainees enrolled on Advanced Communication Skills Training (ACST) courses at Treetops Hospice. As in (2) above, this survey also tracked trainee experiences before and after training,

and at six-month follow-up. (See Section 2.5).

4. Online qualitative interviews with samples of both trainers and trainees, to gather additional in-depth insights into user experiences, values, and needs. (See Sections 3 and 4).

The project commenced in March 2023 and was completed in June 2024.