Skip to main content

Advertisement

Log in

Developing and Implementing an Advanced Communication Training Program in Oncology at a Comprehensive Cancer Center

  • Published:
Journal of Cancer Education Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Epstein R, Street RL Jr (2007) Patient-centered communication in cancer care: promoting healing and reducing suffering. In: Institute NC (ed) Bethesda, MD

  2. ACGME Outcome Project (2006) Enhancing residency education through outcomes assessment. Accessed 18 Aug 2006

  3. 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

  4. US Department of Health and Human Services (2000) Healthy people 2010. US Department of Health and Human Services, Washington DC

  5. Sanson-Fisher RW, Girgis A, Boyes A et al (2000) The unmet supportive care needs of patients with cancer. Cancer 88:225–236

    Article  Google Scholar 

  6. Hack TF, Degner LF, Parker P (2005) The communication goals and needs of cancer patients; a review. Psycho-Oncology 14:831–845

    Article  PubMed  Google Scholar 

  7. Butow PN, Brown RF, Cogar S, Tattersall MHN, Dunn SM (2002) Oncologists’ reactions to cancer patients verbal cues. Psycho-Oncology 11:47–58

    Article  PubMed  CAS  Google Scholar 

  8. 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

    Article  PubMed  CAS  Google Scholar 

  9. 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

    Article  PubMed  Google Scholar 

  10. 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

    Article  PubMed  Google Scholar 

  11. Dikici MF, Yaris F, Cubukcu M (2009) Teaching medical students how to break bad news: a Turkish experience. J Cancer Educ 24:246–248

    Article  PubMed  Google Scholar 

  12. Tavakol M, Murphy R, Torabi S (2008) Educating doctors about breaking bad news: an Iranian perspective. J Cancer Educ 23:260–263

    Article  PubMed  Google Scholar 

  13. 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

    Article  PubMed  CAS  Google Scholar 

  14. 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

    Article  PubMed  Google Scholar 

  15. 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

    Article  PubMed  Google Scholar 

  16. 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

    Article  PubMed  Google Scholar 

  17. 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

    Article  PubMed  Google Scholar 

  18. 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

    Article  PubMed  CAS  Google Scholar 

  19. 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

    Article  PubMed  Google Scholar 

  20. 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

    Google Scholar 

  21. Brown RF, Bylund CL (2008) Communication skills training: describing a new conceptual model. Acad Med 83:37–44

    Article  PubMed  Google Scholar 

  22. Cegala DJ, Broz SL (2002) Physician communication skills training; a review of the theoretical backgrounds, objectives and skills. Med Educ 36:1004–1016

    Article  PubMed  Google Scholar 

  23. Back AL, Arnold RM, Baile WF, Tulsky JA, Fryer-Edwards K (2009) What makes education in communication transformative? J Cancer Educ 24:160–162

    Article  PubMed  Google Scholar 

  24. Kurtz S, Silverman J, Draper J (1998) Teaching and learning communication skills in medicine. Radcliffe Medical Press Ltd, Abingdon

    Google Scholar 

  25. 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

    Article  PubMed  Google Scholar 

  26. Hafferty FW (1998) Beyond curriculum reform: confronting medicine’s hidden curriculum. Acad Med 73:403–407

    Article  PubMed  CAS  Google Scholar 

  27. 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

    Article  PubMed  Google Scholar 

  28. 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

    Article  PubMed  Google Scholar 

  29. 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

    Article  PubMed  Google Scholar 

  30. 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

    Article  PubMed  Google Scholar 

  31. Kirkpatrick DL (1967) Evaluation of training. In: Craig R, Bittlel I (eds) Training and development handbook. McGraw Hill, New York

    Google Scholar 

  32. 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

    Chapter  Google Scholar 

  33. 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

    Article  PubMed  Google Scholar 

  34. 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

    Chapter  Google Scholar 

  35. 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

    Article  PubMed  CAS  Google Scholar 

  36. 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

    Article  PubMed  Google Scholar 

  37. 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

    Article  PubMed  Google Scholar 

  38. 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

    Article  PubMed  Google Scholar 

  39. 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

    Article  PubMed  CAS  Google Scholar 

  40. 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

    Article  PubMed  Google Scholar 

  41. 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

    Article  PubMed  Google Scholar 

  42. Rosenzweig M, Clifton M, Arnold R (2007) Development of communication skills workshop for oncology advanced practice nursing students. J Cancer Educ 22:149–153

    Article  PubMed  Google Scholar 

Download references

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

Authors

Corresponding author

Correspondence to Carma L. Bylund.

Rights and permissions

Reprints 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

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13187-011-0226-y

Keywords

Navigation