Table 7 The Teach to Talk (TtT) programme

1. Video screening. Participants are asked to watch didactic videos representing clinical consultations in which the communication skills involved in the above-mentioned tasks are practiced by actors.

2. Didactic lesson. Subsequently, the participants are provided with an introductory didactic lesson concerning the communication skills needed to deliver bad news, how to explore patients’ concerns and how to build empathy. The discussion between the trainees is focused on both issues from the videos and from the presentation of an actual scenario chosen by the participants. This component is delivered in three hours.

3. Role playing. Beginning in the week after the lesson, role playing sessions are organized, each involving no more than 4 physicians, in which 2 act as actors and the others as observers. Two consecutive role-playing sessions are scheduled at a time, each one lasting about one and half hours. The communication scenarios are proposed by the participants and are based on real situations that they have experienced on the field.

4. Bed-side training. Each participant is supported by a member of the PCT implementing the program in conducting a number of consultations with in- or out-patients, where difficult communication tasks are involved. Bed-side trainings (three per participant) are planned with trainees after the completion of the role play sessions. Each bed-side training is preceded by a briefing aimed at sharing communication objectives and how to manage different scenarios, and the trainings are followed/concluded by a debriefing in which the trainee’s strengths and weaknesses concerning the performed communication tasks are discussed. The Breaking bad news assessment schedule (BAS) is used to guide the discussion [44].

5. Follow-up. The follow-up phase takes place 6 months later and consists of 2 bed-side trainings per participant, featuring the structure described above.

The entire program should be concluded in 6-10 weeks.