Empathic Patient-Oriented Communication in Cancer Care Course: Program Design and Evaluation

Abstract

There is a lack of effective training for health professional (HP) in approaching and managing challenging communication. The purpose of this study was to evaluate the impact of a blended curriculum in communication on HP competence and knowledge. Following a needs assessment using a 1-5 Likert scale on perceived competence in various aspects of communication, an interprofessional, blended curriculum was developed to advance competence and training in challenging conversations in cancer. The blended curriculum consisted of 5 eLearning modules: communication styles, speaking in plain language, principles of breaking bad news, principles for incident disclosure and fundamentals of resilience and coping. Two patient experience videos were recorded. A reflective practice forum was created for the video vignettes to foster resilience skills. Following this asynchronous training a 3-hour in-person, facilitated, skills development session with standardized patients was held. Trainees participated in 4 standardized scenarios. A pre/post evaluation design was used to evaluate self-perceived competence (4-items) and knowledge acquisition (13-items). The McNemar-Bawer Chi Squared test was used to compare self-assessed competency scores and paired T-Tests were used to compare knowledge acquisition scores pre and post course. Learner satisfaction was collected post course. Sixty-one interprofessional trainees completed the needs assessment. The overall perceived competence for breaking bad news was 2.3 (1-5) and the importance was 3.7 (2-4), for incident disclosure was 2.2 (1-4) and importance 3.6 (2-4) and for highly emotional encounters 2.5 (1-5) and importance 3.6 (2-4). The top needs identified were greater knowledge in these areas and opportunities for simulation. Thirty-one trainees completed the pre and 18 the post assessment. There was a significant increase in self-perceived competency following course completion in 2 of 4 competency domains: disclosing an incident to patient/family (p-value=0.046), and breaking bad news (p-value=0.011). There was a trend towards a significant difference in knowledge acquisition scores pre (M=7.47, SD=2.36) and post ((M=6.50, SD-2.31); t(14)=2.12, p=0.053). Course satisfaction was high with 79% (26/33) (reporting that they were ‘confident’ to”totally’ confident that they have mastered the techniques in difficult conversations. 79% (26/33) reported they ‘likely’ to ‘definitely’ intend on using these techniques in their work. 93.76% (30/33) stated they ‘intend to’ ‘are likely to’ or will ‘definitely’ continue to practice communication skills after the training. Overall, 100% said they would recommend this course to a colleague. A blended curriculum offered to advance HCP competence and training in challenging conversations in cancer can build HCP perception of competence and knowledge.