Impact of Flexible Communication Skills Training on Healthcare Professionals’ Communication Knowledge and Confidence

Impact of Flexible Communication Skills Training on Healthcare Professionals’ Communication Knowledge and Confidence | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Short Report Impact of Flexible Communication Skills Training on Healthcare Professionals’ Communication Knowledge and Confidence Gabriel Hooper, Mindy J. Vanderloo, Kristin Akers, Emma Braun, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6864165/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Effective communication is critical to high-quality patient care, yet healthcare professionals often feel unprepared for complex conversations. This quality improvement study evaluated whether a flexible communication training program could enhance HCP knowledge and confidence across professional roles. Method Adapted from VitalTalk™, the curriculum included interactive lectures, skills practice with trained actors, and peer/facilitator feedback, delivered virtually or in person. Results A total of 102 HCPs enrolled; 64 (63%) completed pre-, post-, and 1-month follow-up surveys. Knowledge and confidence scores improved significantly post-training and were largely sustained at 1-month. Physicians reported higher confidence than nurses and advanced practice providers (APPs), though knowledge scores did not differ by profession. Confidence in addressing emotion was retained at follow-up, while confidence in quickly establishing trust declined. Conclusion These findings suggest that brief, flexible communication training improves HCP confidence and knowledge, though ongoing practice may be needed to maintain gains. This model may support interprofessional training with minimal disruption to clinical schedules. communication skills training VitalTalk Communication confidence health care professionals Figures Figure 1 Introduction Communication is foundational to the patient-healthcare professional relationship. Effective communication is associated with improved patient adherence, satisfaction, and health. 1 , 2 , 3 Despite the availability of training courses, healthcare professionals (HCP) continue to report feeling unprepared for difficult and complex communication. 4 Time and accessibility are barriers to attending trainings, underscoring the need for flexible training courses. 5 In this quality improvement study, we aimed to assess if flexible communication training could improve HCP communication knowledge and confidence across professional healthcare roles. Methods This training was adapted from VitalTalk™ and included: 1) brief interactive lectures, 2) skills practice with trained actors, and 3) real-time peer and facilitator feedback. Content focused on: responding to emotion, conflict, disclosing error, and delivering serious news. Six communication classes were held between 10/2022 and 11/2023. Each class enrolled a HCP cohort who attended 2 to 3 sessions for a total of 4 to 6 training hours. Prioritizing flexibility, the course was offered virtually and in person. Participants were surveyed on their knowledge and confidence in communication skills prior to the course, at course completion, and 1 month after the course. Items were scored on a five-point Likert scale of Strongly Disagree (1) to Strongly Agree (5). Composite knowledge and confidence scores were constructed by averaging 6–7 questions in each category, where 5 is a high score. Questions related to establishing rapport and addressing emotion were compared using Wilcoxon signed rank test and a linear mixed effect model, respectively. Linear mixed effect models were used to assess differences by profession. This study was acknowledged by the University of Utah IRB (#00134460). Results In total, 102 HCP enrolled in the classes and 64 (63%) participated in 121 surveys (58 pre-, 40 post-, 23 1-month-post surveys). Surveys were completed by 28 physicians, 12 Advanced Practice Providers (APPs), 10 nurses, and 14 missing or ‘other’ healthcare professionals (e.g., support staff, supervisors, coordinators, chaplains, etc.). Knowledge and confidence scores across all HCPs improved significantly post-course and at 1-month (Table 1 ). There were no significant differences in knowledge between HCP types (Table 1 ). Across all surveys, physicians reported higher confidence compared to nurses and APPs (Table 1 ). On the pre-course survey, most participants endorsed knowing the importance of establishing relationships (mean 4.4, SD 0.7) and recognizing emotions (4.6, SD 0.5); however, confidence in establishing rapport and respond to emotion was lower [3.8 (SD 0.8) and 3.7 (SD 0.8)] (Fig. 1 ). Confidence in these skills improved significantly at course completion (Fig. 1 ). HCP reported sustained improvement in confidence to address emotion after 1 month; however, confidence to establish trust quickly was not maintained (Fig. 1 ). Discussion Our study demonstrates training with flexible time and travel commitments meets the needs of HCPs and improves knowledge and confidence in communication skills. While knowledge of communication skills was as high across all HCP types, confidence in these skills was lower in nursing and other staff when compared to physicians and APPs. This gap in confidence between professions may be related to differences in training. 6 Interestingly, prior to the course, most HCPs recognized the importance of foundational communication skills yet endorsed lower confidence in using these skills. All participants, regardless of profession, reported improvement in confidence following the course. Notably, confidence in responding to emotion but not in establishing trust was retained after 1 month suggesting follow up trainings or skills practice may be needed to maintain confidence across skills. As skills practice is vital to change behavior, we do believe meaningful training with small, repeated practice can create a lasting impact. This study has several limitations. First, this is a small cohort and survey participation rates waned overtime. Second, 1-month follow up surveys may not capture durable change in communication confidence. Last, confidence may not be a representative surrogate of practice change or impact on patient outcomes. In conclusion, a brief in-person or virtual communication training can effectively improve knowledge and confidence in communication skills across a variety of HCPs; however, follow-up training may be necessary to maintain these skills and the confidence to use them. Further study is planned on the effectiveness of flexible interprofessional health care communication training, particularly longitudinally and how the significant findings of this training can be translated to clinical practice and patient-centered outcomes. Table 1 Comparison of Knowledge and Confidence over time and between HCP types. Category Variable Comparison Estimated Mean Difference (95% CI) p-value Knowledge Time (Post-Course) - (Pre-Course) 0.431 (0.276, 0.585) < 0.001 (1mo Post-Course) - (Pre-Course) 0.337 (0.131, 0.542) 0.002 (1mo Post-Course) - (Post-Course) -0.094 (-0.309, 0.121) 0.386 Profession* APP - Nurse 0.304 (-0.23, 0.838) 0.439 MD - Nurse 0.461 (-0.017, 0.94) 0.063 MD - APP 0.158 (-0.247, 0.562) 0.729 Other - Nurse 0.294 (-0.222, 0.81) 0.434 Other - APP -0.01 (-0.526, 0.507) > 0.999 Other - MD -0.167 (-0.618, 0.283) 0.754 Leadership Yes - No 0.495 (0.167, 0.823) 0.004 Confidence Time (Post-Course) - (Pre-Course) 0.588 (0.425, 0.751) < 0.001 (1mo Post-Course) - (Pre-Course) 0.355 (0.138, 0.573) 0.002 (1mo Post-Course) - (Post-Course) -0.232 (-0.459, -0.006) 0.045 Profession* APP - Nurse 0.252 (-0.294, 0.799) 0.358 MD - Nurse 0.691 (0.203, 1.18) 0.006 MD - APP 0.439 (0.023, 0.855) 0.039 Other - Nurse 0.491 (-0.045, 1.026) 0.071 Other - APP 0.238 (-0.299, 0.776) 0.377 Other - MD -0.201 (-0.67, 0.269) 0.394 Leadership Yes - No 0.497 (0.051, 0.942) 0.030 1 To adjust for multiple comparisons, a Tukey adjustment for a family of 4 estimates was used when computing p-values and confidence intervals for the pairwise comparisons between professions. Declarations Conflict of interest: Authors C.C. and K.A. have part of their salary paid to teach this course and author K.A. is a Board Member of hospice and palliative credentialing center. Funding: This investigation was supported by the University of Utah Study Design and Biostatistics Center, with funding in part from the National Center for Research Resources and the National Center for Advancing Translational Sciences, National Institutes of Health, through Grant UM1TR004409 (formerly UL1TR002538). Auth C.C. received funding from the Division of Internal Medicine, University of Utah Health to attend the SGIM national conference and present data as a poster. Author contribution: G.H. contributed to the writing of this manuscript, M.J.V. contributed to the writing of this manuscript, data collection, and conceptual approach, K.A. facilitated the course, contributed to the writing of this manuscript, and conceptual approach, E.B. conducted the statistical analyses and contributed to the writing of this manuscript, M.C. contributed to the writing of this manuscript and conceptual approach, and C.C. facilitated the course, contributed to the writing of this manuscript, and conceptual approach. Human Ethics and Consent to Participate: This study was acknowledged as non-human subjects research by the University of Utah Institutional Review Board (IRB #00134460) and documentation of consent was waived. Availability of data and materials: The datasets generated during and/or analyzed during the current study are not available because of the potential exposure of sensitive employee information, particularly in small and unique hospital groups. Acknowledgements: Resiliency Center at the University of Utah Health References Zolnierek, K.B.H. and DiMatteo, M.R., 2009. Physician communication and patient adherence to treatment: a meta-analysis. Medical care , 47 (8), pp.826-834. DOI: 10.1097/MLR.0b013e31819a5acc Boissy, A., Windover, A.K., Bokar, D., Karafa, M., Neuendorf, K., Frankel, R.M., Merlino, J. and Rothberg, M.B., 2016. Communication skills training for physicians improves patient satisfaction. Journal of general internal medicine , 31 , pp.755-761. DOI: https://doi.org/10.1007/s11606-016-3597-2 Allenbaugh, J., Corbelli, J., Rack, L., Rubio, D. and Spagnoletti, C., 2019. A brief communication curriculum improves resident and nurse communication skills and patient satisfaction. Journal of General Internal Medicine , 34 , pp.1167-1173. DOI: https://doi.org/10.1007/s11606-019-04951-6 Monden, K.R., Gentry, L. and Cox, T.R., 2016, January. Delivering bad news to patients. In Baylor University Medical Center Proceedings (Vol. 29, No. 1, pp. 101-102). Taylor & Francis. DOI: 10.1080/08998280.2016.11929380 Ward, J., and Wood, M. 2000. Education and training of healthcare staff: the barriers to its success. European journal of cancer care , 9 (2), pp.80-85. DOI: https://doi.org/10.1046/j.1365-2354.2000.00205.x Lockwood, B.J., Gustin, J., Verbeck, N., Rossfeld, K., Norton, K., Barrett, T., Potts, R., Towner-Larsen, R., Waterman, B., Radwany, S. and Hritz, C., 2022. Training to promote empathic communication in graduate medical education: a shared learning intervention in internal medicine and general surgery. Palliative Medicine Reports , 3 (1), pp.26-35. DOI: https://doi.org/10.1089/pmr.2021.003 Foronda, C., MacWilliams, B. and McArthur, E., 2016. Interprofessional communication in healthcare: An integrative review. Nurse education in practice , 19 , pp.36-40. DOI: https://doi.org/10.1016/j.nepr.2016.04.005 Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6864165","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Short Report","associatedPublications":[],"authors":[{"id":502571713,"identity":"8310f36d-ae23-412d-8d73-897b9b64362c","order_by":0,"name":"Gabriel Hooper","email":"","orcid":"","institution":"University of Utah","correspondingAuthor":false,"prefix":"","firstName":"Gabriel","middleName":"","lastName":"Hooper","suffix":""},{"id":502571714,"identity":"18d9307e-008e-46a4-825e-c1f6b7c53f35","order_by":1,"name":"Mindy J. Vanderloo","email":"","orcid":"","institution":"University of Utah Health","correspondingAuthor":false,"prefix":"","firstName":"Mindy","middleName":"J.","lastName":"Vanderloo","suffix":""},{"id":502571716,"identity":"0e648303-4b2b-4028-af91-9438fb1666d4","order_by":2,"name":"Kristin Akers","email":"","orcid":"","institution":"University of Utah Health","correspondingAuthor":false,"prefix":"","firstName":"Kristin","middleName":"","lastName":"Akers","suffix":""},{"id":502571717,"identity":"9a293c8e-3d30-4bf8-ad99-385882ff6fab","order_by":3,"name":"Emma Braun","email":"","orcid":"","institution":"University of Utah","correspondingAuthor":false,"prefix":"","firstName":"Emma","middleName":"","lastName":"Braun","suffix":""},{"id":502571721,"identity":"c975b514-0a63-4ad2-a554-6166665940c7","order_by":4,"name":"Megan Call","email":"","orcid":"","institution":"University of Utah Health","correspondingAuthor":false,"prefix":"","firstName":"Megan","middleName":"","lastName":"Call","suffix":""},{"id":502571723,"identity":"215ec390-e408-44ad-b801-a97326962bc7","order_by":5,"name":"Claire Ciarkowski","email":"data:image/png;base64,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","orcid":"","institution":"University of Utah Health","correspondingAuthor":true,"prefix":"","firstName":"Claire","middleName":"","lastName":"Ciarkowski","suffix":""}],"badges":[],"createdAt":"2025-06-10 14:38:17","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6864165/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6864165/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":89642464,"identity":"167760c9-2d24-47bb-b371-6ea93b8755dd","added_by":"auto","created_at":"2025-08-22 08:19:35","extension":"jpeg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":270459,"visible":true,"origin":"","legend":"\u003cp\u003eChange in knowledge and confidence in establishing rapport quickly and responding to emotion. Knowledge was assessed using Wilcoxon signed rank test comparing pre and post-course, but there was not sufficient data to assess pre-course to 1 month post-course for these knowledge questions. Confidence questions were analyzed using a linear mixed effect model. * = p value \u0026lt;0.05 compared to pre-course score.\u003c/p\u003e","description":"","filename":"floatimage1.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-6864165/v1/b955ee6708b117f9460e3020.jpeg"},{"id":94102514,"identity":"371eab37-b60c-427a-a7ee-b9fe279fc55b","added_by":"auto","created_at":"2025-10-22 11:31:49","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":698274,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6864165/v1/dfd99605-11d4-4439-b804-6678b86294f7.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Impact of Flexible Communication Skills Training on Healthcare Professionals’ Communication Knowledge and Confidence","fulltext":[{"header":"Introduction","content":"\u003cp\u003eCommunication is foundational to the patient-healthcare professional relationship. Effective communication is associated with improved patient adherence, satisfaction, and health.\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e,\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e,\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u003c/sup\u003e Despite the availability of training courses, healthcare professionals (HCP) continue to report feeling unprepared for difficult and complex communication.\u003csup\u003e\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u003c/sup\u003e Time and accessibility are barriers to attending trainings, underscoring the need for flexible training courses.\u003csup\u003e\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u003c/sup\u003e In this quality improvement study, we aimed to assess if flexible communication training could improve HCP communication knowledge and confidence across professional healthcare roles.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eThis training was adapted from VitalTalk™ and included: 1) brief interactive lectures, 2) skills practice with trained actors, and 3) real-time peer and facilitator feedback. Content focused on: responding to emotion, conflict, disclosing error, and delivering serious news. Six communication classes were held between 10/2022 and 11/2023. Each class enrolled a HCP cohort who attended 2 to 3 sessions for a total of 4 to 6 training hours. Prioritizing flexibility, the course was offered virtually and in person. Participants were surveyed on their knowledge and confidence in communication skills prior to the course, at course completion, and 1 month after the course. Items were scored on a five-point Likert scale of Strongly Disagree (1) to Strongly Agree (5). Composite knowledge and confidence scores were constructed by averaging 6–7 questions in each category, where 5 is a high score. Questions related to establishing rapport and addressing emotion were compared using Wilcoxon signed rank test and a linear mixed effect model, respectively. Linear mixed effect models were used to assess differences by profession. This study was acknowledged by the University of Utah IRB (#00134460).\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eIn total, 102 HCP enrolled in the classes and 64 (63%) participated in 121 surveys (58 pre-, 40 post-, 23 1-month-post surveys). Surveys were completed by 28 physicians, 12 Advanced Practice Providers (APPs), 10 nurses, and 14 missing or \u0026lsquo;other\u0026rsquo; healthcare professionals (e.g., support staff, supervisors, coordinators, chaplains, etc.).\u003c/p\u003e\u003cp\u003eKnowledge and confidence scores across all HCPs improved significantly post-course and at 1-month (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). There were no significant differences in knowledge between HCP types (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). Across all surveys, physicians reported higher confidence compared to nurses and APPs (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e On the pre-course survey, most participants endorsed knowing the importance of establishing relationships (mean 4.4, SD 0.7) and recognizing emotions (4.6, SD 0.5); however, confidence in establishing rapport and respond to emotion was lower [3.8 (SD 0.8) and 3.7 (SD 0.8)] (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). Confidence in these skills improved significantly at course completion (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). HCP reported sustained improvement in confidence to address emotion after 1 month; however, confidence to establish trust quickly was not maintained (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eOur study demonstrates training with flexible time and travel commitments meets the needs of HCPs and improves knowledge and confidence in communication skills. While knowledge of communication skills was as high across all HCP types, confidence in these skills was lower in nursing and other staff when compared to physicians and APPs. This gap in confidence between professions may be related to differences in training.\u003csup\u003e\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003cp\u003eInterestingly, prior to the course, most HCPs recognized the importance of foundational communication skills yet endorsed lower confidence in using these skills. All participants, regardless of profession, reported improvement in confidence following the course. Notably, confidence in responding to emotion but not in establishing trust was retained after 1 month suggesting follow up trainings or skills practice may be needed to maintain confidence across skills. As skills practice is vital to change behavior, we do believe meaningful training with small, repeated practice can create a lasting impact.\u003c/p\u003e\u003cp\u003eThis study has several limitations. First, this is a small cohort and survey participation rates waned overtime. Second, 1-month follow up surveys may not capture durable change in communication confidence. Last, confidence may not be a representative surrogate of practice change or impact on patient outcomes.\u003c/p\u003e\u003cp\u003eIn conclusion, a brief in-person or virtual communication training can effectively improve knowledge and confidence in communication skills across a variety of HCPs; however, follow-up training may be necessary to maintain these skills and the confidence to use them. Further study is planned on the effectiveness of flexible interprofessional health care communication training, particularly longitudinally and how the significant findings of this training can be translated to clinical practice and patient-centered outcomes.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eComparison of Knowledge and Confidence over time and between HCP types.\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCategory\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eVariable\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eComparison\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eEstimated Mean Difference (95% CI)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003ep-value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eKnowledge\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eTime\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e(Post-Course) - (Pre-Course)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.431 (0.276, 0.585)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e(1mo Post-Course) - (Pre-Course)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.337 (0.131, 0.542)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.002\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e(1mo Post-Course) - (Post-Course)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e-0.094 (-0.309, 0.121)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.386\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eProfession*\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eAPP - Nurse\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.304 (-0.23, 0.838)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.439\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eMD - Nurse\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.461 (-0.017, 0.94)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.063\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eMD - APP\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.158 (-0.247, 0.562)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.729\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eOther - Nurse\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.294 (-0.222, 0.81)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.434\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eOther - APP\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e-0.01 (-0.526, 0.507)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;0.999\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eOther - MD\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e-0.167 (-0.618, 0.283)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.754\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eLeadership\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eYes - No\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.495 (0.167, 0.823)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.004\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eConfidence\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eTime\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e(Post-Course) - (Pre-Course)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.588 (0.425, 0.751)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e(1mo Post-Course) - (Pre-Course)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.355 (0.138, 0.573)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.002\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e(1mo Post-Course) - (Post-Course)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e-0.232 (-0.459, -0.006)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.045\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eProfession*\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eAPP - Nurse\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.252 (-0.294, 0.799)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.358\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eMD - Nurse\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.691 (0.203, 1.18)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.006\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eMD - APP\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.439 (0.023, 0.855)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.039\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eOther - Nurse\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.491 (-0.045, 1.026)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.071\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eOther - APP\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.238 (-0.299, 0.776)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.377\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eOther - MD\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e-0.201 (-0.67, 0.269)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.394\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eLeadership\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eYes - No\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.497 (0.051, 0.942)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.030\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003eTo adjust for multiple comparisons, a Tukey adjustment for a family of 4 estimates was used when computing p-values and confidence intervals for the pairwise comparisons between professions.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eConflict of interest:\u0026nbsp;\u003c/strong\u003eAuthors C.C. and K.A. have part of their salary paid to teach this course and author K.A. is a Board Member of\u0026nbsp;hospice and palliative credentialing center.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u0026nbsp;\u003c/strong\u003eThis investigation was supported by the University of Utah Study Design and Biostatistics Center, with funding in part from the National Center for Research Resources and the National Center for Advancing Translational Sciences, National Institutes of Health, through Grant UM1TR004409 (formerly UL1TR002538). Auth C.C. received funding from the Division of Internal Medicine, University of Utah Health to attend the SGIM national conference and present data as a poster.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor contribution:\u003c/strong\u003e G.H. contributed to the writing of this manuscript, M.J.V. contributed to the writing of this manuscript, data collection, and conceptual approach, K.A. facilitated the course, contributed to the writing of this manuscript, and conceptual approach, E.B. conducted the statistical analyses and contributed to the writing of this manuscript, M.C. contributed to the writing of this manuscript and conceptual approach, and C.C. facilitated the course, contributed to the writing of this manuscript, and conceptual approach. \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eHuman Ethics and Consent to Participate:\u003c/strong\u003e This study was acknowledged as non-human subjects research by the University of Utah Institutional Review Board (IRB #00134460) and documentation of consent was waived.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials:\u003c/strong\u003e The datasets generated during and/or analyzed during the current study are not available because of the potential exposure of sensitive employee information, particularly in small and unique hospital groups.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements:\u0026nbsp;\u003c/strong\u003eResiliency Center at the University of Utah Health\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eZolnierek, K.B.H. and DiMatteo, M.R., 2009. Physician communication and patient adherence to treatment: a meta-analysis. \u003cem\u003eMedical care\u003c/em\u003e, \u003cem\u003e47\u003c/em\u003e(8), pp.826-834. DOI:\u0026nbsp;10.1097/MLR.0b013e31819a5acc\u003c/li\u003e\n \u003cli\u003eBoissy, A., Windover, A.K., Bokar, D., Karafa, M., Neuendorf, K., Frankel, R.M., Merlino, J. and Rothberg, M.B., 2016. Communication skills training for physicians improves patient satisfaction. \u003cem\u003eJournal of general internal medicine\u003c/em\u003e, \u003cem\u003e31\u003c/em\u003e, pp.755-761. DOI: https://doi.org/10.1007/s11606-016-3597-2\u003c/li\u003e\n \u003cli\u003eAllenbaugh, J., Corbelli, J., Rack, L., Rubio, D. and Spagnoletti, C., 2019. A brief communication curriculum improves resident and nurse communication skills and patient satisfaction. \u003cem\u003eJournal of General Internal Medicine\u003c/em\u003e, \u003cem\u003e34\u003c/em\u003e, pp.1167-1173. DOI: https://doi.org/10.1007/s11606-019-04951-6\u003c/li\u003e\n \u003cli\u003eMonden, K.R., Gentry, L. and Cox, T.R., 2016, January. Delivering bad news to patients. In \u003cem\u003eBaylor University Medical Center Proceedings\u003c/em\u003e (Vol. 29, No. 1, pp. 101-102). Taylor \u0026amp; Francis. DOI: 10.1080/08998280.2016.11929380\u003c/li\u003e\n \u003cli\u003eWard, J., and Wood, M. 2000. Education and training of healthcare staff: the barriers to its success. \u003cem\u003eEuropean journal of cancer care\u003c/em\u003e, \u003cem\u003e9\u003c/em\u003e(2), pp.80-85. DOI: https://doi.org/10.1046/j.1365-2354.2000.00205.x\u003c/li\u003e\n \u003cli\u003eLockwood, B.J., Gustin, J., Verbeck, N., Rossfeld, K., Norton, K., Barrett, T., Potts, R., Towner-Larsen, R., Waterman, B., Radwany, S. and Hritz, C., 2022. Training to promote empathic communication in graduate medical education: a shared learning intervention in internal medicine and general surgery. \u003cem\u003ePalliative Medicine Reports\u003c/em\u003e, \u003cem\u003e3\u003c/em\u003e(1), pp.26-35. DOI: https://doi.org/10.1089/pmr.2021.003\u003c/li\u003e\n \u003cli\u003eForonda, C., MacWilliams, B. and McArthur, E., 2016. Interprofessional communication in healthcare: An integrative review. \u003cem\u003eNurse education in practice\u003c/em\u003e, \u003cem\u003e19\u003c/em\u003e, pp.36-40. DOI: https://doi.org/10.1016/j.nepr.2016.04.005\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"communication skills training, VitalTalk, Communication confidence, health care professionals","lastPublishedDoi":"10.21203/rs.3.rs-6864165/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6864165/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003e Effective communication is critical to high-quality patient care, yet healthcare professionals often feel unprepared for complex conversations. This quality improvement study evaluated whether a flexible communication training program could enhance HCP knowledge and confidence across professional roles.\u003c/p\u003e\u003ch2\u003eMethod\u003c/h2\u003e\u003cp\u003eAdapted from VitalTalk\u0026trade;, the curriculum included interactive lectures, skills practice with trained actors, and peer/facilitator feedback, delivered virtually or in person.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eA total of 102 HCPs enrolled; 64 (63%) completed pre-, post-, and 1-month follow-up surveys. Knowledge and confidence scores improved significantly post-training and were largely sustained at 1-month. Physicians reported higher confidence than nurses and advanced practice providers (APPs), though knowledge scores did not differ by profession. Confidence in addressing emotion was retained at follow-up, while confidence in quickly establishing trust declined.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e\u003cp\u003eThese findings suggest that brief, flexible communication training improves HCP confidence and knowledge, though ongoing practice may be needed to maintain gains. This model may support interprofessional training with minimal disruption to clinical schedules.\u003c/p\u003e","manuscriptTitle":"Impact of Flexible Communication Skills Training on Healthcare Professionals’ Communication Knowledge and Confidence","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-08-22 08:11:31","doi":"10.21203/rs.3.rs-6864165/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"8756c20f-25d1-4c90-8b94-479688e0f0e5","owner":[],"postedDate":"August 22nd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-10-22T11:23:44+00:00","versionOfRecord":[],"versionCreatedAt":"2025-08-22 08:11:31","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6864165","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6864165","identity":"rs-6864165","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}