Instructional Modules to Improve Cancer Communication

描述(申请人提供)：癌症患者的故事，他们与癌症的生活在他们的声音和面部传达，可以作为强大和有效的工具，以改善临床医生之间的沟通照顾癌症患者。这个项目将开发和测试五个故事驱动的、交互式的多媒体模块(SIM)，这些模块基于现实生活中的患者和临床医生的故事。这些模块旨在帮助临床医生更好地处理癌症患者的护理和沟通。 根据初步研究中发现的问题，单元主题将包括：1)坏消息，2)安然度过风暴：通过治疗，3)从治疗过渡到姑息临终关怀，4)关于癌症护理中宗教/精神因素的适当沟通，以及5)对癌症患者家属的有效沟通和支持。每个单元都将是高度互动的，并将充满许多癌症患者的故事，这些故事阐明了某些沟通的必要性，并用患者自己的话说，就如何最有效地满足他们的需求提供建议。这些故事将被引出，五个模块将围绕爱泼斯坦博士和斯特里特的NCI专著《癌症护理中的以患者为中心的沟通》中描述的以患者为中心的沟通和癌症护理的概念模型进行开发。 在开发了这些模块后，每个模块都将在一组住院医生、研究员和三年级医学生中进行测试，他们将被分配到SIMS组或控制干预组。参与者将通过干预前后进行的客观结构化临床评估(欧安组织)进行评估。与我们开发的其他模块一样，我们预计在体验了互动模块后，所展示的沟通技能将有相当大的改善。我们预计，患者实际使用的语言和故事的自由使用将进一步增强对临床医生行为的影响。 该项目具有许多独特的优势，包括通过来自医疗通信、临床肿瘤学和讲故事领域的跨专业专家小组的合作努力获取和使用癌症患者的故事。拟议的项目包括一个评估要素，以评估由此产生的模块对住院医生和医科学生与癌症患者有效沟通的能力的实际影响。在完成对这些模块的有效性的教育评估后，这些模块将在美国各地提供给有兴趣改善以患者为中心的癌症患者与患者沟通的项目和临床医生。

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.