Prospective survey study regarding the implementation of new communication skills curriculum for medical oncology trainees.

Abstract

9058 Background: After a diagnosis of cancer, many patients suffer from anxiety and distress from uncertainty of symptoms, treatments, and prognosis. Clinicians must recognize opportunities to explore concerns. This study assesses oncology trainees’ views about communication with cancer patients before (PRE) and after (POST) a 12 month curriculum. Methods: Medical oncology fellows were surveyed PRE and POST a communication curriculum consisting of case studies and 6 core lectures which included fundamentals, breaking bad news, transitions to palliative care, advanced care planning, conducting family conferences, and discussing treatment options and informed consent. A 5 point Likert-scale was used to measure fellows’ attitudes and comfort regarding communication PRE and POST with questions grouped according to core topics. (≤2 = trainee disagreement, 3=neutral opinion, and ≥ 4 indicated agreement). Results: PRE and POST surveys were completed by 11 and 8 trainees respectively. In PRE 100% felt communication skills were important and 63% believed these skills could be taught. 82% felt there was not enough time during most visits to address emotion. This decreased to 27% in POST. 18% PRE agreed they were comfortable recognizing coping mechanisms versus 100% POST. 45% felt comfortable eliciting values in PRE versus 87.5% POST. Only 1 fellow (9%) felt comfortable addressing futility in PRE versus 25% in POST. The median grouped score for fundamentals increased from 15 to 17 (p=0.016) and median grouped score for advance care plans and DNR increased from 11 to 13(p=0.026). Conclusions: There is a need to improve oncology communication skills. Our curriculum is just one approach. After intervention, the majority of fellows agreed there was enough time to address emotion and felt more comfortable recognizing coping mechanisms and eliciting values. Discussing futility remains difficult for our fellows. All fellows were more comfortable with fundamental communication skills and advance care plans after the curriculum. The extent the curriculum contributed to the change in survey results is unclear. Further research is needed to guide communication education of oncologists.