Communication Skills Education Program for Oncology

肿瘤学沟通技巧教育计划

• 批准号: 8249466
• 负责人: Carma L. Bylund
• 金额: $ 32.4万
• 依托单位: SLOAN-KETTERING INST CAN RESEARCH
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-05-01 至 2015-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8249466
• 关键词: Adverse effects; Cancer Education Grant Program; Caring; Childhood; Clinic; Clinical; Communication; Competence; Complex; Comprehensive Cancer Center; Consultations; Development; Dose; Education; Educational Curriculum; Educational process of instructing; Effectiveness; Emotional; Ensure; Evaluation; Faculty; Family; Feedback; Foundations; Goals; Intervention; Learning; Medical; Medical Oncology; Memorial Sloan-Kettering Cancer Center; Oncologist; Operative Surgical Procedures; Outcome; Participant; Patient Outcomes Assessments; Patients; Perception; Performance; Physicians; Process; Program Development; Radiation Oncology; Reaction; Research; Risk; Self Assessment; Self Efficacy; Surgical Oncology; Testing; Training; Work; improved; oncology; oncology program; outcome forecast; palliative; programs; psychological distress; public health relevance; response; skills; skills training; uptake

DESCRIPTION (provided by applicant): Effective communication between physician and patient is the foundation of quality medical care. In the oncology setting, physician-patient communication is particularly important because oncologists discuss difficult issues with patients. These conversations typically include discussing prognosis, ensuring patient and family understand the prominent risks and side-effects of treatments, assessing and responding to psychological distress, managing the transition of care from a curative to palliative goal, and working to accept the dying process. Research suggests that oncologists, particularly newly trained oncologists, receive little training in how to communicate effectively about such issues. As a result, patients have unmet informational and emotional needs and their adaptation across the course of care is influenced by the interaction with and support they receive from the clinician. Over the course of the last decade, interventions to improve communication skill and efficacy have been developed and tested in RCTs, and have proven efficacy in altering physician communication. The establishment of programs of advanced communication skills training at Comprehensive Cancer Centers is a key training need for oncology nationally. This application responds to this need with a careful examination of an educational program piloted at Memorial Sloan-Kettering Cancer Center. The overall goal of this proposal is to develop a Communication Skills Education Program for Oncology. This program will be supported through three cores: an Education Core, a Faculty Development and Training Core, and an Evaluation Core. The specific aims of this proposal are: Aim 1: To implement through an Education Core a communication training curriculum for Comprehensive Cancer Centers to improve the ability of medical, surgical, and pediatric fellows and junior faculty to communicate with patients and families effectively about complex oncological issues; Aim 2: To support this communication training curriculum through a Faculty Development and Training Core. This training core will maintain a faculty development program for attending physicians and will offer continuing training and feedback to facilitators to better teach communication skills; Aim 3: To assess through an Evaluation Core the outcomes of these programs on fellows and junior faculty through examination at several levels including: self-assessment, performance in standardized patient assessments, performance in clinical encounters, and patient reported outcomes. In this proposal, we will demonstrate the efficacy of a 7-module educational program on 264 participants and evaluate its effectiveness through the use of the Kirkpatrick's triangle of evaluation strategies from level 1, reaction of learners, to level 2, self-efficacy of learning and skill uptake via standardized patient assessments, to level 3, transfer of skills into the clinic, and finally at level 4, patient outcome in response to the consultation for 896 patients assessed. We hypothesize that dose of training will directly impact skill uptake, will explore the proportion of variance in skill uptake attributable to facilitator competence and assess the change pre to post training in patient's perception of the quality of the clinician's communication. PUBLIC HEALTH RELEVANCE: This specialized R25 cancer education program for oncologists will develop and trial a comprehensive communication skills training curriculum aimed at improving the ability of medical, surgical and radiation oncology faculty and fellows to communicate with patients and families effectively about complex oncological issues.

描述（由申请人提供）：医生和患者之间的有效沟通是优质医疗服务的基础。在肿瘤学环境中，医患沟通尤为重要，因为肿瘤学家与患者讨论困难的问题。这些对话通常包括讨论预后，确保患者和家属了解治疗的突出风险和副作用，评估和应对心理困扰，管理护理从治疗到姑息治疗的过渡，以及努力接受死亡过程。研究表明，肿瘤学家，特别是新培训的肿瘤学家，在如何有效地沟通这些问题方面接受的培训很少。因此，患者的信息和情感需求未得到满足，他们在整个护理过程中的适应受到与临床医生的互动和支持的影响。在过去的十年中，改善沟通技巧和有效性的干预措施已经在RCT中开发和测试，并已证明在改变医生沟通方面的有效性。在综合癌症中心建立高级沟通技能培训计划是全国肿瘤学的关键培训需求。这个应用程序响应了这一需要，仔细检查了在纪念斯隆-凯特琳癌症中心试点的教育计划。 本提案的总体目标是制定肿瘤学沟通技能教育计划。该计划将通过三个核心得到支持：教育核心，教师发展和培训核心以及评估核心。该提案的具体目标是：目标1：通过教育核心为综合癌症中心实施沟通培训课程，以提高医疗，外科和儿科研究员和初级教师与患者和家属就复杂的肿瘤学问题进行有效沟通的能力;目标2：通过教师发展和培训核心支持这一沟通培训课程。这个培训核心将保持主治医生的教师发展计划，并将提供持续的培训和反馈，以促进更好地教授沟通技巧;目标3：通过评估核心评估这些计划对研究员和初级教师的结果，通过考试在几个级别，包括：自我评估、标准化患者评估中的表现、临床遭遇中的表现以及患者报告的结果。 在本提案中，我们将在264名参与者中证明7个模块的教育计划的有效性，并通过使用柯克帕特里克三角评估策略评估其有效性，从1级，学习者的反应，到2级，通过标准化患者评估学习和技能吸收的自我效能，到3级，将技能转移到诊所，最后在4级，评估了896例患者的咨询结果。我们假设，剂量的培训将直接影响技能吸收，将探讨的比例变化，可归因于促进能力的技能吸收和评估的变化前培训后患者的感知质量的临床医生的沟通。 公共卫生相关性：这个针对肿瘤学家的专业R25癌症教育计划将开发和试验全面的沟通技能培训课程，旨在提高内科、外科和放射肿瘤学教师和研究员就复杂的肿瘤问题与患者和家人有效沟通的能力。