Advanced Communication Skills Training Research Articles

The Effectiveness of Basic and Advanced Communication Skills Training on the Quality of Interpersonal Relationships and Organizational Commitment

The Effectiveness of Basic and Advanced Communication Skills Training on the Quality of Interpersonal Relationships and Organizational Commitment

Return to valued activities: Survivors' experiences of adaptation and growth after treatment for head and neck cancer.

The objective of this study was to explore the experiences of head and neck cancer (HNC) survivors who returned to valued activities to understand how they reconstruct their lives following HNC diagnosis and treatment. A qualitative research approach based on social constructionist theory was used. A total of 21 in-depth semi-structured interviews were conducted with adults diagnosed with any type of HNC in the previous 6years. Reflexive thematic analysis was used to identify themes. HNC presents a unique trauma following which some survivors navigate paths back to meaningful activities. The experiences of HNC survivors who adapted to life after treatment described internal and external change and development, identified by three themes; Mindfulness; Gratitude; and Adaptation. People diagnosed with HNC frequently experience lasting effects and other survivorship issues, however some survivors were able to return to valued activities and recreate a meaningful lifestyle reflecting the possibility of post traumatic growth. This study provides insight into the experiences of head and neck cancer survivors who were able to make meaning and find internal and external growth following treatment. These findings can be used to inform advanced communication skills training for oncology health professionals and psychoeducational courses for people diagnosed with head and neck cancer in the future.

Burnout or Fade Away; experiences of health professionals caring for patients with head and neck cancer

The oncology workforce has been found to have high risk of burnout; however, limited research has explored the experiences of health professionals working with head and neck cancer patients. The objective of this qualitative study was to explore the experiences of health professionals who work directly with patients diagnosed with head and neck cancers, with a focus on work-life balance, mental health and wellbeing. A total of 21 in-depth semi-structured interviews were conducted with health professionals including radiation oncologists, medical oncologists, nurses, and associated medical and allied health professionals. A qualitative research approach based on social constructionist theory was used. Thematic analysis was used to identify and code themes. Five main themes emerged: 1. Conscientiousness; 2. Empathy; 3. Challenges; 4. Coping; and 5. Burnout or Fade Away. Challenges included sub-themes of Time & Resource Constraints, Work-Life Imbalance, Patients with Complex Needs, and Lack of Self-Care. It is vital to the sustainability of head and neck oncology services that this highly skilled workforce is retained. The development of interventions that will reduce the risk of burnout and improve retention and capacity of health professionals may include advanced communication skills training, trauma sensitivity training, self-compassion and stress management skills.

Protocol for a randomised trial of an interprofessional team-delivered intervention to support surrogate decision-makers in ICUs

IntroductionAlthough shortcomings in clinician–family communication and decision making for incapacitated, critically ill patients are common, there are few rigorously tested interventions to improve outcomes. In this manuscript, we present our...

Consult, Negotiate, and Involve: Evaluation of an Advanced Communication Skills Program for Health Care Professionals

Effective communication is central to children, young people, and their families' experiences of health care. Most patient complaints in developed health care systems result from ineffective communication, including inadequate information provision, not feeling listened to, failure to value patients concerns, and patients not feeling involved in care decisions. Advanced communication skills training is now embedded within cancer care policy in the United Kingdom and now features prominently within cancer education in many countries. Here, we share findings from a research evaluation of an advanced communication skills training program dedicated to health professionals caring for children and young people with cancer. We evaluated participants' (n = 59) perceptions of the program, impact on their skills, knowledge, competence, and confidence. An appreciative inquiry design was adopted; data included interviews, precourse-postcourse evaluations, e-mail blog survey, and 360-degree reflective work records. The framework approach underpinned data analysis and triangulation of data sets. Key findings highlighted good and poor practice in health professionals' engagement with children, young people, and their families; the purpose of communicating effectively was not always consistent with collaborative working. Attending a program helped participants expand their knowledge of communication theories and strategies. Participants valued using simulated scenarios to develop their skills and were keen to use their new skills to enhance care delivery. Our emphasis within this evaluation, however, remained on what was communicated, when and how, rather than to what effect. The impact of programs such as these must now be evaluated in terms of patient benefit.

Pivotal role of families in doctor-patient communication in oncology: a qualitative study of patients, their relatives and cancer clinicians.

Families are a unique source of support for many cancer patients. Most advanced communication skills training for oncologists are patient centred and do not cover interactions with family members. The current study used in-depth qualitative interviews of patients, relatives and cancer clinicians with thematic analysis to explore the role of family members in the communication process. Forty-one participants included 10 cancer patients, 10 relatives ensuring proportionate representation of both gender and primary cancer site and 21 doctors representing both medical and surgical oncology. Nineteen of 20 patients and relatives wanted an "open and honest" discussion with their doctors. All patients, relatives and doctors preferred involvement of the family at most stages of cancer treatment. Five themes were identified in relation to communication with family members. The participants highlighted the "importance of family for physical and psychological care," they emphasised the need to "balance patient autonomy and relatives desire to be protective" using varied "negotiating strategies" that are influenced by "socioeconomic circumstances of both patient and family." The doctor-patient-relative communication process was not static with preferences changing over time. The data suggests that communication skills training of cancer clinicians should incorporate modules on better communication with relatives.

Big Five Personality Traits and Assertiveness do not Affect Mastery of Communication Skills

BackgroundMastering communication skills is often emphasized as an important aspect of job or academic performance. However, research into the relationships between personality factors and these skills is scarce. PurposeThis study investigated whether the big-five personality factors and assertiveness predict mastery of communication skills before and after following communication skills training. MethodThe skills level of 143 psychology students was assessed after two communication skills courses, namely a basic and an advanced communication skills training. Personality factors were assessed with the Five Factor Personality Inventory and the Scale for Interpersonal Behavior. ResultsParticipants showed substantial progress in their mastery of the communication skills after both courses. Surprisingly, none of the personality factors predicted the level of mastery of these skills. DiscussionThis seems to imply that trainees can become professional communicators, regardless of their scores on these personality factors.

Communication skills in psychiatry training.

Mental health clinicians can experience problems communicating distressing diagnostic information to patients and their families, especially about severe mental illnesses such as schizophrenia. Evidence suggests that interpersonal communication skills can be effectively taught, as has been demonstrated in the specialty of oncology. However, very little literature exists with respect to interpersonal communication skills training for psychiatry. This paper provides an overview of the communication skills training literature. The report reveals significant gaps exist and highlights the need for advanced communication skills training for mental health clinicians, particularly about communicating a diagnosis and/or prognosis of schizophrenia. A new communication skills training framework for psychiatry is described, based on that used in oncology as a model. This model promotes applied skills and processes that are easily adapted for use in psychiatry, providing an effective platform for the development of similar training programs for psychiatric clinical practice.

The Use and Correlation of Patient Reported Outcome Measures (PROMs) in a Hospital Outpatient Setting

BackgroundConsultation And Relational Empathy (CARE) and Patient Enablement Instrument (PEI) PROMs were highlighted by a task group of the association of palliative care as useful research tools for assessment of...

Training the powerful: issues that emerged during the evaluation of a communication skills training programme for senior cancer care professionals

'Connected' is the name of the national advanced communication skills training programme developed in 2008 for cancer care professionals in the NHS. A 3-day training course combining didactic and experiential learning elements is run by two facilitators with course participants expected to engage fully in simulated consultations with trained actors. In 2011, and as a result of participant feedback on the length of the course and increasing pressures on budgets and clinical time, the Connected team developed and piloted an alternative 2-day training course. Before its roll-out in 2012, Birmingham City University was commissioned to evaluate the effectiveness and quality of the 2-day course vis-à-vis the 'traditional' 3-day one. This article is written by the two evaluators and it discusses some of the issues that emerged during the evaluation. We broadly grouped these issues into two overlapping categories: the mandatory nature of the course and the different professional background and seniority of participants. In our discussion we consider the implications these issues have for communication skills training policy and practice and put forward suggestions for further research.

P45 Communicating with care, in an ever increasingly complex world

BackgroundWithin the last decade, numerous white papers have been published to improve care for palliative care patients. The principle of effective communication is at the heart of clinical practice and...

Advanced communication skills training for senior clinicians

Effective communication skills are important for patient care, and patients and their families value good communication highly. But in practice communication is sometimes poor, leading to frustration, despair, strained doctor-patient relationships, and complaints. So, to improve communication skills a national programme was set up in accordance with the NHS cancer plan (2000), reinforced by the National Institute for Health and Clinical Excellence guidance on supportive and palliative care (2004). It is a learner centred course for training in advanced communication skills. It includes workshops that entail role play and feedback. The main aim is to improve communication skills and to learn how to be an effective communicator. …

Nursing students’ perceptions of obesity and behaviour change: Implications for undergraduate nurse education

Rates of obesity are rising and previous research suggests this is not effectively dealt with in healthcare settings. Nurses are increasingly involved in lifestyle management of patients, and understanding the barriers to discussing weight with patients is likely to increase successful weight management. Obesity management is a role that nursing students will need to be equipped with and more likely to be targeted for future training developments in tackling the increasing rates of obesity. To explore the perceptions of obesity, potential barriers to successful patient weight management and training needs of nursing students. Qualitative, semi-structured interviews were conducted with 20 nursing students. Audiotaped interviews were transcribed verbatim and analysed using an inductive thematic approach informed by principles of grounded theory. Participants reported the challenge of managing obesity in healthcare practice, such as the impact of negative attitudes in healthcare practice on patient care. Although perceived as core to their training, nursing students lacked the confidence and techniques to discuss weight management with patients. Participants also perceived the nursing curriculum as lacking a focus on obesity, and reported a need for advanced communication skills training. Although seen as important, nurses lack the skills to facilitate weight management, leading to nurses failing to broach the issue. Nurse educators should consider the perceptions of current students when making curriculum developments in this area.

Teaching error disclosure: Advanced communication skills training for residents

Disclosing errors to patients is an advanced communication skill necessary in clinical practice but traditionally not taught during residency training. We developed an educational seminar for senior residents utilizing didactic, small group discussion, and role play that incorporates principles of error disclosure. Our objectives were to improve resident's knowledge of the key components of disclosing medical errors to patients and to provide opportunity to practice communicating medical error in a safe environment. We assessed whether residents are participating in error disclosure and compared self-rated preparedness to disclose an error before and after the teaching session. Nearly all residents (94%) reported that learning about disclosure of medical errors is a very important part of residency training and 58% of residents had already participated in a disclosure discussion. Residents reported they were significantly more prepared to disclose medical errors to patients after participating in the curriculum compared with before, both in terms of the components of medical error disclosure and the emotional aspects of disclosure. This curriculum was associated with improvement in comfort level with error disclosure. Error disclosure represents an ideal educational opportunity for residencies to address multiple core competencies including patient care, communication skills, and professionalism.

What is the impact of training nurses in resuscitation decisions in advanced illness?

BackgroundThe East Midlands DNA-CPR form may be completed by a ‘suitably experienced nurse’. The BMA and RCN statement (2007) indicated that nurses may make such decisions, but ambiguity about training...

Developing and Implementing an Advanced Communication Training Program in Oncology at a Comprehensive Cancer Center

Cancer patients report significant levels of unmet needs in the realm of communication. Communication skills training programs have been shown to improve clinical communication. However, advanced communication skills training programs in oncology have lacked institutional integration, and thus have not attended to institutional norms and cultures that may counteract explicit communication skills training. We developed and implemented an advanced communication skills training program made up of nine teaching modules for faculty, fellows, and residents. Training included didactic and experiential small group work. Self-efficacy and behavior change were assessed for individual participants. Since 2006, 515 clinicians have participated in this training program. Participants have shown significant gains in self-efficacy regarding communicating with patients in various contexts. Our initial work in this area demonstrates the implementation of such a program at a major cancer center to be feasible, to be acceptable, and to have a significant impact on participants' self-efficacy.

Mandatory communication skills training for cancer and palliative care staff: Does one size fit all?

Purpose of the research There is increasing recognition of the importance of good communication between healthcare professionals and patients facing cancer or end of life. In England, a new national 3-day training programme called ‘Connected’ has been developed and is now mandatory for all cancer and palliative care professionals. This study aimed to explore the attitudes of staff in one region to undertaking this training. Methods and sample A survey questionnaire was developed through a series of discussions with experts and semi-structured interviews with five healthcare professionals. The questionnaire was distributed to 200 cancer and palliative care staff; 109 were completed and returned. Key results There were significant differences between doctors’ and nurses’ attitudes to communication skills training, with doctors demonstrating more negative attitudes. More nurses than doctors felt that communication skills training should be mandatory for cancer and palliative care professionals ( p ≤ 0.001), whilst more doctors felt that these staff should already be skilled communicators and not require further training ( p ≤ 0.001). Nurses also self-rated their communication skills more highly than doctors. Conclusions The current ‘one size fits all’ approach being taken nationally to advanced communication skills training does not meet the training preferences of all healthcare professionals, and it is recommended that tailoring courses to individuals’ needs should be considered.

Revised UK guidelines for the management of cutaneous melanoma 2010

These guidelines for the management of cutaneous melanoma present an evidence-based guidance for treatment, with identification of the strength of evidence available at the time of preparation of the guidelines, and a brief overview of epidemiology, diagnosis, investigation, and follow-up.

Breaking bad news of cancer to people with learning disabilities

Accessible summary When some one gets cancer the doctor, most times, tells them about it and does not keep it a secret. Because this can be very upsetting, the government pays for special training to help doctors and nurses to do this well. The training does not include anything about the needs of people with learning disabilities. Some people with learning disabilities were asked whether the doctor had told them when they were ill, and most of them said ‘no’. Learning disability staff need to help doctors and nurses understand how to speak to people with learning disabilities. People with learning disabilities need to understand about their illness and be involved in decisions about their treatment. SummarySince the 1970s, medical staff have routinely disclosed the diagnosis of cancer to their patients. However, this has often been carried out unskilfully causing distress to the patient and impairing their ability to comply with treatment. In response, the government has invested in ‘Advanced Communication Skills training’ for oncology staff. Despite the subsequent advances made in communicating with the general public, this article will show that a small‐scale audit of people with learning disabilities demonstrated that often doctors do not communicate directly with people with learning disabilities about serious illness. It will also suggest that, the current ‘breaking bad news’ models do not meet the communication needs of people with learning disabilities. This article explores the findings of the audit and its implications for practice and ends by sign posting to useful resources for communicating the bad news of a life‐threatening illness to people with learning disabilities.