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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