Supporting clinical and non-clinical staff to have challenging conversations with patients, relatives and colleagues: online simulation with live actors

The Brief:

This case study aims to highlight the implementation of a workshop designed to enhance communication skills and strategies for managing challenging conversations in a healthcare environment. The workshop targeted NHS staff, both clinical and non-clinical, with the goal of improving their ability to initiate and handle difficult interactions with colleagues, patients, and relatives/carers. The study examines the impact of the workshop on participants’ skills, knowledge, confidence, and overall workplace dynamics.

The Problem:

In a healthcare setting, effective communication during challenging conversations is crucial for maintaining trust, resolving issues, and ensuring a positive experience for all parties involved. Poorly managed interactions can lead to negative escalation, erode trust, and result in complications, distress, and potential errors. Furthermore, inadequate communication skills can hinder team collaboration and adversely affect patient and relative satisfaction.

The Requirement:

The objective was to develop a workshop that equipped healthcare staff with communication strategies and techniques to handle challenging conversations with kindness and compassion. The training aimed to address various scenarios, including colleague-to-colleague interactions (via Teams meetings), frustrated relatives (phone calls), isolated patients (video consultations), and unsafe colleagues (face-to-face encounters). The workshop was designed to be delivered online, considering the geographical size of the NHS Trust.

The Outcome:

Over a period of three years, a total of 300 NHS staff participated in the workshop, which consisted of a month-long design process followed by annual online deliveries of six sessions each. The content covered active listening, empathy, communication strategies, appreciative inquiry, values exploration, and reflective exercises. The scenarios presented were authentic and relatable, effectively simulating real-life encounters.

Tangible Results:

Evaluation of the workshop revealed positive outcomes. Participants consistently reported that their skills and knowledge had improved, and they felt more confident in managing challenging conversations. The scenarios were deemed relevant and authentic, and the online format provided a safe environment for practicing new skills. The involvement of actors in the simulation exercises was highly beneficial, as their feedback offered unique insights. Participants appreciated receiving feedback from peers and expressed gratitude for the opportunity to learn from each other.


Over the course of three years, staff members from a large NHS Trust have actively engaged in online workshops focused on developing their skills in managing challenging conversations. The workshops incorporated live simulations involving “real” patients, relatives/carers, and colleagues, enabling participants to understand the root causes of conflict and practice effective strategies. Feedback from participants consistently highlighted the value of the training and their increased confidence in engaging in mutually positive conversations, thereby preventing escalation. The positive reception of the workshop has resulted in ongoing requests for additional training sessions, indicating a high level of satisfaction and the potential for wider implementation among colleagues.