Educating hematology-oncology fellows about how to communicate with patients about cancer clinical trials: A needs assessment.

Abstract

9029 Background: Cancer clinical trials (CCTs) are vital to advancing treatment yet only 5-8% of people with cancer ever participate, with even lower rates among underserved groups. Teaching oncologists in training how to communicate about CCTs may improve the frequency and quality of patient-oncologist communication about CCTs and increase participation. However, little is known about interest in or feasibility of such training during Hematology-Oncology (Hem-Onc) graduate medical education (GME) fellowships. We aimed to determine Hem-Onc fellowship programs’: 1) current practices, needs, and preferences for CCT-related communication training; and 2) the acceptability and feasibility of implementing a CCT communication skills workshop. Methods: We recruited and surveyed program directors (PDs) from Hem-Onc fellowship programs across the U.S. PDs were recruited via email through the ASCO program directors’ community, a publicly accessible list of ACGME Hematology-Oncology programs, and co-authors’ professional networks. Participants were compensated with a $50 gift card. Survey data were analyzed using descriptive statistics and responses were measured on a 5-point Likert scale (1 = “strongly disagree” to 5 = “strongly agree”). Results: 40 PDs were surveyed, most representing programs in the Northeast (30%), Midwest (25.6%), Southeast (20.5), and Southwest (15.4%) U.S. Most were male (57%) and identified as White (55%), Asian (30%), Black/African American (2.5%) and Native American/Alaskan Native (2.5%). PDs stated their institutions prioritize CCT accrual (M=4.58, SD=.78) and clinical research training (M=4.20, SD=.85). They reported their GME CCT curriculum least often addressed: (1) How to talk to patients about CCTs when none are available (27.5%), and (2) How to help patients find CCTs at other institutions (17.5%). PDs rated their fellows’ CCT knowledge as lowest in: (1) Provider-level barriers to enrolling/referring patients in CCTs (M=3.41, SD=.91) and (2) System-level barriers to patient accrual to CCTs (M=3.33, SD=.95). Fellows’ lowest-rated CCT communication skills areas were: (1) Making shared decisions with patients about CCT participation (M=3.54, SD=1.14) and (2) Patient-centered communication (M=3.50, SD=1.15). PDs were interested in a CCT communication workshop (‘yes’=67.5%, ‘maybe’=32.5%) and said such training was feasible (M=4.28, SD=.78) and useful (M=4.47, SD=.78). Training preferences were live presentations (M=3.9, SD=1.03) and program-tailored virtual workshops (M=3.9, SD=1.08). Conclusions: Hem-Onc fellowship program leaders expressed a need for training that improves fellows’ CCT knowledge and patient-centered communication skills. By highlighting current practices, challenges, and preferences, this study is an important step towards implementing and scaling communication skills training in GME programs.