Communication about uncertainty and hope: A randomized controlled trial assessing the efficacy of a communication skills training program for physicians caring for cancer patients

Darius Razavi,Isabelle Merckaert,Isabelle Bragard,Aurore Liénard,Livia Peternelj,Yves Libert,Christine Reynaert

doi:10.1186/s12885-017-3437-8

Abstract

BackgroundAlthough previous studies have reported the efficacy of communication skills training (CST) programs, specific training addressing communication about uncertainty and hope in oncology has not yet been studied. This paper describes the study protocol of a randomized controlled trial assessing the efficacy of a CST program aimed at improving physician ability to communicate about uncertainty and hope in encounters with cancer patients.Methods/designPhysician participants will be randomly assigned in groups (n = 3/group) to a 30-h CST program (experimental group) or to a waiting list (control group). The training program will include learner-centered, skills-focused, practice-oriented techniques. Training efficacy is assessed in the context of an encounter with a simulated advanced stage cancer patient at baseline and after the CST for the experimental group, and after four months for the waiting-list group. Efficacy assessments will include communicational, psychological and physiological measures. Group-by-time effects will be analyzed using a generalized estimating equation (GEE). A power analysis indicated that a sample size of 60 (30 experimental and 30 control) participants will be sufficient to detect effects.DiscussionThe current study will aid in the development of effective CST programs to improve physician ability to communicate about uncertainty and hope in encounters with cancer patients.Trial registrationUS Clinical Trials Register NCT02836197.

Highlights

Previous studies have reported the efficacy of communication skills training (CST) programs, specific training addressing communication about uncertainty and hope in oncology has not yet been studied
Prior studies have indicated that cancer patients have an expectation that physicians will discuss uncertainty and hope [4] to help them adjust to their diagnosis [1, 5, 6] and to maintain hopefulness [7,8,9]
Aim of the trial A randomized longitudinal study assessing the efficacy of a CST program aimed at improving physician communication about uncertainty and hope with cancer patients will be conducted

Summary

Background

Communication with cancer patients poses a variety of widely recognized challenges for physicians. Previous studies have reported on the efficacy of communication skills training (CST) programs in the improvement of low- to middle-level communication skills of physicians such as breaking bad news to cancer patients, assessing psychosocial issues and talking with patient relatives [33]. CST programs have used learnercentered, skill-focused and practice-oriented techniques resulting in improvements in physician communication and support skills [34,35,36,37], attitudes toward psychosocial and emotional issues [30, 38,39,40,41], empathy toward patients [38, 39, 42] and work satisfaction [36] These programs have benefited patients by decreasing anxiety [43] and increasing satisfaction [44, 45]. This collaborative and bidirectional process of communication between physician and patient on sensitive topics associated with the patient’s medical, psychological and social future will benefit both patient and physician

Methods/design

Findings

Discussion