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Scientific Research

Qualitative Science

RPD320 - Interprofessional Teamwork in Serious Illness Communication: A Multi-Method Pilot Study

Thursday, March 5, 2026
2:30pm - 4:00pm PST
Location: Room 30 AB
Disclosure(s):
Jaclyn Shameklis, MD: No financial relationships to disclose
Joanna Paladino, MD: No financial relationships to disclose
Alexis Drutchas, MD: No financial relationships to disclose
Mahima Jain, MPH: No financial relationships to disclose
Lindsay A. Dow, MD MS: No financial relationships to disclose
Michaela Rowland, AGPCNP-BC, AOCNP, ACHPN: No financial relationships to disclose
Carine Davila, MD MPH: No financial relationships to disclose
Elizabeth Lindenberger, MD: No financial relationships to disclose
Key Message : Characterizing clinician roles, communication norms, and interprofessional team culture is vital to improving serious illness communication in patient care. Understanding these dynamics can inform strategies and interventions that strengthen interprofessional teamwork and improve serious illness communication delivery across care settings.

Abstract:

Introduction: Serious illness communication (SIC) relies on interprofessional teamwork (1,2). Despite efforts to train interprofessional teams in SIC (3,4,5), little is known about how team culture shapes SIC delivery. Understanding these dynamics can help improve collaboration and establish shared responsibility.

Objective: Characterize clinician roles, communication norms, and team culture related to SIC.

Methods: We conducted a multi-method pilot study to examine interprofessional engagement and role perception in SIC. Interprofessional clinicians were recruited from two specialties - amyotrophic lateral sclerosis (ALS) and gynecologic oncology - chosen due to leadership support. Quantitative data from a cross-sectional survey assessed SIC attitudes, roles, and team norms. Qualitative data from semi-structured interviews and focus groups explored team dynamics, facilitators, and barriers. Survey data were analyzed descriptively; qualitative data underwent thematic analysis.

Results: Twenty-one clinicians participated in the survey (8 ALS, 13 oncology): 9 physicians (43%), 8 nurse practitioners (38%), 2 speech-language pathologists (10%), 1 physical therapist (5%), and 1 social worker (5%). Given the small sample, respondents were grouped as MD and non-MD. Most respondents in both groups (84-88%) rejected the idea that hierarchy limited participation in SIC. However, only 17% of non-MDs compared to 55% of MDs felt highly empowered to initiate SIC. While most MDs (79%) agreed team discussions about SIC were common, only 50% of non-MDs agreed. Eleven clinicians completed interviews or focus groups. Qualitative data revealed three key themes: (1) Clinicians described highly varied formal and informal roles in SIC; (2) Facilitators of effective interprofessional SIC included shared values, respect, and collaborative communication; (3) Barriers to interprofessional SIC included care fragmentation, inpatient and outpatient transitions, and misaligned views on SIC timing.

Conclusion: Findings reveal how interprofessional team culture influences SIC practices. Addressing these dynamics can inform team-based training and implementation strategies to improve SIC delivery and ultimately improve patient care.

References: 1. Lakin JR, Benotti E, Paladino J, Henrich N, Sanders J. Interprofessional Work in Serious Illness Communication in Primary Care: A Qualitative Study. J Palliat Med. 2019 Jul;22(7):751-763. doi: 10.1089/jpm.2018.0471. Epub 2019 Jan 28. PMID: 30688549.

2. Paladino J, Brannen E, Benotti E, et al. Implementing Serious Illness Communication Processes in Primary Care: A Qualitative Study. Am J Hosp Palliat Care. 2021 May;38(5):459-466. doi: 10.1177/1049909120951095. Epub 2020 Aug 14. PMID: 32794412.

3. Beddard-Huber E, Strachan P, Brown S, et al. Supporting Interprofessional Engagement in Serious Illness Conversations: An Adapted Resource. J Hosp Palliat Nurs. 2021 Feb 1;23(1):38-45. doi: 10.1097/NJH.0000000000000712. PMID: 33136801.

4. Izumi SS, Caron D, Guay-Bélanger S, et al. Development and Evaluation of Serious Illness Conversation Training for Interprofessional Primary Care Teams. J Palliat Med. 2023 Sep;26(9):1198-1206. doi: 10.1089/jpm.2022.0268. Epub 2023 Apr 11. PMID: 37040304.

5. Gomes Souza L, Archambault PM, Asmaou Bouba D, et al; Meta-LARC ACP Cluster Randomized Trial team. Impact of a team-based versus individual clinician-focused training approach on primary healthcare professionals' intention to have serious illness conversations with patients: A theory-informed process evaluation embedded within a cluster randomized trial. PLoS One. 2025 Mar 26;20(3):e0298994. doi: 10.1371/journal.pone.0298994. PMID: 40138335; PMCID: PMC11940443.

Learning Objectives:

  • Describe how interprofessional team culture—including communication norms, roles, and hierarchy—shapes the delivery of serious illness communication in clinical practice.
  • Identify strategies to strengthen interprofessional collaboration and shared responsibility for serious illness communication across clinical disciplines.