Training and collaboration
We trained healthcare professionals with 1) an introductory presentation for physicians and nurses of the GSD method and how to use it in this study; 2) two workshops, a GSD reading list and follow-up supervised exercises and individual observation sessions with a certificated GSD supervisor (BCHK) for nurses. To ensure fidelity in using the GSD method the nurses filled out a predefined reflection sheet after every fifth conversation focusing on how they used the communication skills (mirroring, active listening, and values clarification response). These reflections were discussed with the GSD supervisor (BCHK). Nurses had continuous access to the supervisor by e-mail and phone contact whenever they needed support and weekly phone meetings between the nurses and the GSD supervisor. We adapted the medical report to also include documentation on the nurses’ use of GSD principles. Physicians developed and refined the standardized medical record, communicated with the GSD supervisor to get information about the nurses’ training, and met regularly with the nurses to discuss psychological, organizational, and structural challenges.