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Table 1 MCA complex intervention components

From: The Heidelberg Milestones Communication Approach (MCA) for patients with prognosis <12 months: protocol for a mixed-methods study including a randomized controlled trial

Intervention component Subcomponent Content
Communication training Two training sessions with simulated patients and video assessment
Two training sessions in a clinical setting including individualized feedback
Coaching
MCA conversation components
Communication skills
Attitude
Empathy
Prognostic awareness
Milestone conversations Diagnosis Breaking bad news
Treatment options
Outlining follow-up and contact with nurse
Stable phase Question-prompt-list
Prognostic awareness
Advance care planning
Palliative care needs
Progression Question-prompt-list
Breaking bad news
Prognostic awareness
Treatment options
Advance care planning
Palliative care needs
Transition to best supportive care Question-prompt-list
Breaking bad news
Prognostic awareness
Advance care planning
Symptom treatment
Palliative care needs
Follow-up sessions Patient is contacted every month by telephone or during a routine clinic visit by a nurse Palliative care assessment
Prognostic awareness
Answering patient questions
Referrals if necessary
Material Communication manual for milestone conversations Content of milestone conversations
Training material
Memory cards Quick overview of milestone conversations
Managing symptoms guidebook Brochure for patients on symptom management
Question-prompt-list Questions patients could ask
  1. MCA Milestones Communication Approach