Instructional Modules to Improve Cancer Communication

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DESCRIPTION (provided by applicant): Cancer patients' stories, their lives with cancer as conveyed in their voices and faces, can serve as powerful and effective tools to improve communications among clinicians caring for cancer patients. This project will develop and test five Story-driven, Interactive, Multimedia modules (SIMs) grounded in real-life patient and clinician stories. These modules are designed to help clinicians better deal with the care of and communication with cancer patients. Growing out of issues identified in a pilot study, module topics will include: 1) Breaking Bad News, 2) Weathering the Storm: Living through Treatment, 3) Transitioning from Curative to Palliative End-of-Life Care, 4) Appropriate Communications on Religious/Spiritual Factors in Cancer Care, and 5) Effective Communication and Support for Families of Cancer Patients. Each of the modules will be highly interactive and will be replete with numerous cancer patient stories that illuminate the need for certain communications and provide recommendations, in the patients' own words, on how most effectively to address their needs. The stories will be elicited and the five modules will be developed around a conceptual model of patient-centered communication and cancer care as described in Drs. Epstein's and Street's NCI monograph, "Patient-Centered Communication in Cancer Care." After these modules have been developed, each will be tested with a group of medical residents, fellows, and third-year medical students who will be assigned to the SIMs group or to a control intervention group. Participants will be evaluated by means of an Objective Structured Clinical Evaluation (OSCE) done before and after the interventions. As with other modules we have developed, we anticipate a sizable improvement in demonstrated communications skills after experiencing the interactive modules. We expect that the impact on clinicians' behavior will be further enhanced by the liberal use of patients' actual words and stories. This project has a number of unique strengths that include the acquisition and use of cancer patient stories through a collaborative effort by an inter-professional group of experts from the fields of medical communications, clinical oncology, and storytelling. The proposed project includes an assessment element to evaluate the actual impact of the resulting modules on the ability of residents and medical students to communicate effectively with cancer patients. After the educational evaluation on the effectiveness of the modules has been completed, the modules will be made available throughout the United States to programs and clinicians interested in improving patient-centered cancer communication with their patients.