Communication Skills Education Program for Oncology

描述（申请人提供）：医患之间的有效沟通是优质医疗服务的基础。在肿瘤学领域，医患沟通尤为重要，因为肿瘤学家会与患者讨论疑难问题。这些对话通常包括讨论预后，确保患者和家属了解治疗的主要风险和副作用，评估和应对心理困扰，管理从治疗目标到姑息目标的护理过渡，以及努力接受死亡的过程。研究表明，肿瘤学家，尤其是新近接受培训的肿瘤学家，在如何就此类问题进行有效沟通方面接受的培训很少。因此，患者有未满足的信息和情感需求，他们在整个护理过程中的适应受到与临床医生的互动和他们从临床医生那里得到的支持的影响。在过去的十年中，改善沟通技巧和有效性的干预措施已经被开发出来，并在随机对照试验中进行了测试，并证明了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巧培训项目是全国肿瘤学培训的关键需求。这个应用程序通过对纪念斯隆-凯特琳癌症中心试点的教育项目的仔细检查来回应这一需求。

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.