Abstract
Cancer patients report significant levels of unmet needs in the realm of communication. Communication skills training programs have been shown to improve clinical communication. However, advanced communication skills training programs in oncology have lacked institutional integration, and thus have not attended to institutional norms and cultures that may counteract explicit communication skills training. We developed and implemented an advanced communication skills training program made up of nine teaching modules for faculty, fellows, and residents. Training included didactic and experiential small group work. Self-efficacy and behavior change were assessed for individual participants. Since 2006, 515 clinicians have participated in this training program. Participants have shown significant gains in self-efficacy regarding communicating with patients in various contexts. Our initial work in this area demonstrates the implementation of such a program at a major cancer center to be feasible, to be acceptable, and to have a significant impact on participants' self-efficacy.
Similar content being viewed by others
References
Epstein R, Street RL Jr (2007) Patient-centered communication in cancer care: promoting healing and reducing suffering. In: Institute NC (ed) Bethesda, MD
ACGME Outcome Project (2006) Enhancing residency education through outcomes assessment. Accessed 18 Aug 2006
Institute of Medicine of the National Academies (2004) Improving medical education: enhancing the behavioral and social science content of medical school curricula. Institute of Medicine, Washington DC
US Department of Health and Human Services (2000) Healthy people 2010. US Department of Health and Human Services, Washington DC
Sanson-Fisher RW, Girgis A, Boyes A et al (2000) The unmet supportive care needs of patients with cancer. Cancer 88:225–236
Hack TF, Degner LF, Parker P (2005) The communication goals and needs of cancer patients; a review. Psycho-Oncology 14:831–845
Butow PN, Brown RF, Cogar S, Tattersall MHN, Dunn SM (2002) Oncologists’ reactions to cancer patients verbal cues. Psycho-Oncology 11:47–58
Baile WF, Buckman R, Lenzi R, Glober G, Beale EA, Kudelka AP (2000) SPIKES—a six step protocol for delivering bad news: application to the patient with cancer. Oncologist 5:302–311
Eggly S, Penner L, Albrecht T et al (2006) Discussing bad news in the outpatient oncology clinic: rethinking current communication guidelines. J Clin Oncol 24:716–719
Costantini A, Baile WF, Lenzi R et al (2009) Overcoming cultural barriers to giving bad news: feasibility to promote truth-telling to cancer patients. J Cancer Educ 24:180–185
Dikici MF, Yaris F, Cubukcu M (2009) Teaching medical students how to break bad news: a Turkish experience. J Cancer Educ 24:246–248
Tavakol M, Murphy R, Torabi S (2008) Educating doctors about breaking bad news: an Iranian perspective. J Cancer Educ 23:260–263
Brown RF, Butow PN, Butt DG, Moore AR, Tattersall MHN (2004) Developing ethical strategies to assist oncologists in seeking informed consent to cancer clinical trials. Soc Sci Med 58:379–390
Back AL, Arnold RM (2006) Discussing prognosis: “How much do you want to know?” Talking to patients who do not want information or who are ambivalent. J Clin Oncol 24:4214–4217
Back AL, Arnold RM (2006) Discussing prognosis: “How much do you want to know?” Talking to patients who are prepared for explicit information. J Clin Oncol 24:4209–4213
Back AL, Arnold RM, Baile WF et al (2007) Efficacy of communication skills training for giving bad news and discussing transitions to palliative care. Arch Intern Med 167:453–460
Fallowfield L, Jenkins V, Farewell V, Saul J, Duffy A, Eves R (2002) Efficacy of a cancer research UK communication skills training model for oncologists: a randomised controlled trial. Lancet 359:650–656
Fallowfield L, Jenkins V, Farewell V, Solis-Trapala I (2003) Enduring impact of communication skills training: results of a 12-month follow-up. Br J Cancer 89:1445–1449
Razavi D, Merckaert I, Marchal S et al (2003) How to optimize physicians’ communication skills in cancer care: results of a randomized study assessing the usefulness of posttraining consolidation workshops. J Clin Oncol 21:3141–3149
Brown RF, Bylund CL, Lubrano di Ciccone B, Diamond C, Eddington J, Kissane D (2010) Patient centered communication skills training for oncologists: describing the content and efficacy of training. Commun Educ 59:236–249
Brown RF, Bylund CL (2008) Communication skills training: describing a new conceptual model. Acad Med 83:37–44
Cegala DJ, Broz SL (2002) Physician communication skills training; a review of the theoretical backgrounds, objectives and skills. Med Educ 36:1004–1016
Back AL, Arnold RM, Baile WF, Tulsky JA, Fryer-Edwards K (2009) What makes education in communication transformative? J Cancer Educ 24:160–162
Kurtz S, Silverman J, Draper J (1998) Teaching and learning communication skills in medicine. Radcliffe Medical Press Ltd, Abingdon
Lane C, Rollnick S (2007) The use of simulated patients and role-play in communication skills training: a review of the literature to August 2005. Patient Educ Couns 67:13–20
Hafferty FW (1998) Beyond curriculum reform: confronting medicine’s hidden curriculum. Acad Med 73:403–407
Browning DM, Meyer EC, Truog RD, Solomon MZ (2007) Difficult conversations in health care: cultivating relational learning to address the hidden curriculum. Acad Med 82:905–913
Bylund CL, Brown RF, Lubrano di Ciccone B et al (2008) Training faculty to facilitate communication skills training: development and evaluation of a workshop. Patient Educ Couns 70:430–436
Bylund CL, Brown RF, Lubrano di Ciccone B, Diamond C, Eddington J, Kissane D (2009) Assessing facilitator competence in a comprehensive communication skills training programme. Med Educ 43:342–349
Back AL, Arnold RM, Tulsky JA, Baile WF, Fryer-Edwards KA (2003) Teaching communication skills to medical oncology fellows. J Clin Oncol 21:2433–2436
Kirkpatrick DL (1967) Evaluation of training. In: Craig R, Bittlel I (eds) Training and development handbook. McGraw Hill, New York
Konopasek L, Rosenbaum M, Encandela J, Cole-Kelly K (2010) Evaluating communication skills training courses. In: Kissane DW, Bultz BD, Butow PN, Finlay IG (eds) Handbook of communication in oncology and palliative care. Oxford University Press, Oxford, pp 683–693
Bylund CL, Brown RF, Gugeun JA, Diamond C, Bianculli J, Kissane DW (2010) The implementation and assessment of a comprehensive communication skills training curriculum for oncologists. Psycho-Oncology 19:583–593
Bylund CL, Brown R, Lubrano di Ciccone B, Konopasek L (2010) Facilitating skills practice in communication role play sessions: essential elements and training facilitators. In: Kissane DW, Bultz BD, Butow PN, Finlay IG (eds) Handbook of communication in oncology and palliative care. Oxford University Press, Oxford, pp 597–606
Brown RF, Butow P, Boyle F, Tattersall MHN (2007) Seeking informed consent to cancer clinical trials: evaluating the efficacy of communication skills training. Psycho-Oncology 16:507–516
Hulsman RL, Ros WJG, Winnubst JAM, Bensing JM (2002) The effectiveness of a computer-assisted instruction programme on communication skills of medical specialists in oncology. Med Educ 36:125–134
Delvaux N, Merckaert I, Marchal S et al (2005) Physicians’ communication with a cancer patient and a relative: a randomized study assessing the efficacy of consolidation workshops. Cancer 103:2397–2411
Shilling V, Jenkins V, Fallowfield L (2003) Factors affecting patient and clinician satisfaction with the clinical consultation: can communication skills training for clinicians improve satisfaction? Psycho-Oncology 12:599–611
Lienard A, Merckaert I, Libert Y et al (2006) Factors that influence cancer patients’ anxiety following a medical consultation: impact of a communication skills training programme for physicians. Ann Oncol 17:1450–1458
Lienard A, Merckaert I, Libert Y et al (2008) Factors that influence cancer patients’ and relatives’ anxiety following a three-person medical consultation: impact of a communication skills training program for physicians. Psycho-Oncology 17:488–496
Merckaert I, Libert Y, Delvaux N et al (2008) Factors influencing physicians’ detection of cancer patients’ and relatives’ distress: can a communication skills training program improve physicians’ detection? Psycho-Oncology 17:260–269
Rosenzweig M, Clifton M, Arnold R (2007) Development of communication skills workshop for oncology advanced practice nursing students. J Cancer Educ 22:149–153
Acknowledgments
This study was funded by Arthur Vining Davis Foundation, Josiah H. Macy, Jr. Foundations, and Kenneth B. Schwartz Center.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Bylund, C.L., Brown, R.F., Bialer, P.A. et al. Developing and Implementing an Advanced Communication Training Program in Oncology at a Comprehensive Cancer Center. J Canc Educ 26, 604–611 (2011). https://doi.org/10.1007/s13187-011-0226-y
Published:
Issue Date:
DOI: https://doi.org/10.1007/s13187-011-0226-y