The development and implementation of an institution-based communication skills training program for oncologists.

Abstract

9128 Background: Cancer patients report significant levels of unmet communication needs. Attending to these needs is crucial for optimal care. Communication skills training (CST) programs have been shown to improve clinical communication. However, advanced CST programs in oncology have lacked institutional integration, and thus have not attended to institutional norms and cultures, the “hidden curriculum”, that may counteract explicit communication skills training. The goals of this project were to 1. Develop an evidenced-based CST curriculum; 2. Address the “hidden curriculum” through faculty development; 3. Implement the program for the institution's fellows, residents and faculty; 4. Assess the effectiveness of the program. Methods: We developed an advanced CST program, made up of nine teaching modules, at Memorial Sloan-Kettering Cancer Center through systematic review of the literature which identified commonly used strategies, skills, and behaviors that enhance effective communication in the oncology setting. Training included didactic presentations and experiential small group work. Key faculty were identified to receive CST training and serve as facilitators and role models in the implementation phase. Trainees included residents, fellows, junior and senior faculty. Anonymous course evaluations and pre-post self-efficacy rated on a 5-point Likert scale were completed at the end of each module workshop. Skills uptake and behavior change were evaluated through coding of pre-post video recordings of actual and simulated patient encounters. Data were analyzed using paired sample t-tests. Results: Since 2006, 473 clinicians have participated in this training program. Course satisfaction was rated as Agree/Strongly agree in a range of 92%-97% for all modules. Pre-post self-efficacy significantly increased (p<.01) across modules for both attending physicians and trainees. The use of Establish the Consultation Framework and Checking communication skills were shown to significantly increase from baseline (p<.01) Conclusions: Our initial work in this area demonstrates the implementation of such a program at a major cancer center to be feasible, acceptable, and beneficial. No significant financial relationships to disclose.