Attitudes and Perceptions of the REFLECT Communication Curriculum for Clinical Oncology Graduate Medical Education

Abstract

Background Communication and interpersonal skills are important medical components of oncology patient care. The REFLECT (Respect, Empathy, Facilitate Effective Communication, Listen, Elicit Information, Compassion, and Teach Others) curriculum is a novel communication to improve and refine physician/patient interactions for oncology graduate medical trainees. Each year, this comprehensive course consisted of quarterly (four-hour) workshops comprised of assigned reading, knowledge assessments, didactic lectures, expert guest lecturers, standardized patient (SP) simulations, role-playing, patient/expert panels, coaching, reflective writing, and debriefing/feedback sessions. We sought to evaluate the attitudes and perceptions of the communication curriculum in oncology trainees. Methods Surveys were developed to obtain perceptions of the REFLECT curriculum from trainee (Radiation Oncology and Medical Oncology) participants and faculty mentors. A 9-question and 11-question Likert scale surveys (1 = not beneficial, 5 = beneficial) was distributed to resident/fellow participants and faculty mentors, respectively. Questions asked trainee and faculty opinions about perception of improvement in communication, handling of stressful situations, value of curriculum, and overall impression of the curriculum. Surveys were distributed through Qualtrics, and were anonymous, voluntary, and non-incentivized. Results Twelve resident/fellow participants completed the participant survey. Five (41.6%) Radiation Oncology trainees and 7 (58.3%) Hematology/Oncology fellows completed the survey. Nine faculty members, 8 radiation oncologists and 1 medical oncologist, completed the faculty survey. In general, trainees felt that the curriculum improved their communication skills (mean = 3.5, range 1-5). Additionally, most also felt the workshop was beneficial in being able to handle certain topics (69.2%). Seven participants (54%) felt that the curriculum enhanced their communication. However, only 28.4% of trainees felt it was beneficial to their training. The overall impression was positive, with 77% of participants rating the curriculum as beneficial. Meanwhile, faculty members felt the curriculum was beneficial with average responses ranging from 4.5-5. There was a significantly more positive perception of the REFLECT curriculum among faculty members compared to trainees (p <0.05). Discussion While the REFLECT curriculum was perceived to enhance communication skills, trainees did not find the curriculum beneficial. On the other hand, faculty physicians and staff felt the curriculum was beneficial. As interactive skills and communication is critical to build positive interaction with patients, further work is needed to improve trainee's perception of the REFLECT curriculum. Communication and interpersonal skills are important medical components of oncology patient care. The REFLECT (Respect, Empathy, Facilitate Effective Communication, Listen, Elicit Information, Compassion, and Teach Others) curriculum is a novel communication to improve and refine physician/patient interactions for oncology graduate medical trainees. Each year, this comprehensive course consisted of quarterly (four-hour) workshops comprised of assigned reading, knowledge assessments, didactic lectures, expert guest lecturers, standardized patient (SP) simulations, role-playing, patient/expert panels, coaching, reflective writing, and debriefing/feedback sessions. We sought to evaluate the attitudes and perceptions of the communication curriculum in oncology trainees. Surveys were developed to obtain perceptions of the REFLECT curriculum from trainee (Radiation Oncology and Medical Oncology) participants and faculty mentors. A 9-question and 11-question Likert scale surveys (1 = not beneficial, 5 = beneficial) was distributed to resident/fellow participants and faculty mentors, respectively. Questions asked trainee and faculty opinions about perception of improvement in communication, handling of stressful situations, value of curriculum, and overall impression of the curriculum. Surveys were distributed through Qualtrics, and were anonymous, voluntary, and non-incentivized. Twelve resident/fellow participants completed the participant survey. Five (41.6%) Radiation Oncology trainees and 7 (58.3%) Hematology/Oncology fellows completed the survey. Nine faculty members, 8 radiation oncologists and 1 medical oncologist, completed the faculty survey. In general, trainees felt that the curriculum improved their communication skills (mean = 3.5, range 1-5). Additionally, most also felt the workshop was beneficial in being able to handle certain topics (69.2%). Seven participants (54%) felt that the curriculum enhanced their communication. However, only 28.4% of trainees felt it was beneficial to their training. The overall impression was positive, with 77% of participants rating the curriculum as beneficial. Meanwhile, faculty members felt the curriculum was beneficial with average responses ranging from 4.5-5. There was a significantly more positive perception of the REFLECT curriculum among faculty members compared to trainees (p <0.05). While the REFLECT curriculum was perceived to enhance communication skills, trainees did not find the curriculum beneficial. On the other hand, faculty physicians and staff felt the curriculum was beneficial. As interactive skills and communication is critical to build positive interaction with patients, further work is needed to improve trainee's perception of the REFLECT curriculum.