Effect of adolescent and young adult cancer placements on advanced communication skills.

Abstract

e24182 Background: Communication with adolescent and young adult cancer (AYA) patients and their families can be challenging and requires extensive skills, often developed over time. Medical students can be afraid to encounter such challenges and treating teams can be protective of these vulnerable patients. Therefore, medical students can have little contact and experience communicating with AYA putting them at a disadvantage. We have developed a special study module (SSM) for students with the AYA multi-disciplinary team to promote student awareness of the unique challenges of communicating with AYA patients and provide essential skills for later practice. We present the findings from the first year of this module. Methods: Students at the University of Cambridge were offered a 6-week placement with the AYA cancer service. This involved shadowing members of the multi-professional cancer team and time on the AYA ward to talk with patients and their families in order to practice triadic communication skills. Mid-placement, an experiential learning experience with simulated patients focused on triadic interviews was also offered in line with our local clinical communication skills courses. After the module students were questioned about how they felt this had affected their practice and knowledge of communicating with AYA with cancer. Results: 12 students enrolled for the SSM over the year. All students found the placement widened their communication skills as well as their knowledge of AYA cancers and treatments. 4 main areas of learning were evident. 1.The problems faced by AYA patients as they try to establishing independent adult identities in the midst of severe illness or at the end of life and the implications for the triadic interview. 2. Information sharing during patient denial. 3. The AYA perspective: desire for control and their difficulty of communicating. 4.Challenges of communicating well in emotionally-charged situations. Conclusions: Experiential learning during the placement highlighted techniques for balancing both patient and parental involvement during consultations to maximise efficacy of information gathering. AYA cancer placements provide opportunities to develop advanced communication skills and can be augmented with experiential learning.