Communication Skills Training Research Articles

A compassionate communication skills training course for staff working in cancer services

A compassionate communication skills training course for staff working in cancer services

Liminal Space: A Retrospective Content Analysis of Ethics Consultation for Patients Aged 18–26

PurposeTo characterize the primary ethical issue and contextual features of ethics consultation for patients aged 18–26 years based on setting (adult vs. pediatric). MethodsA retrospective review of 965 ethics consultation notes to identify patients aged 18–26 years cared for in the pediatric or adult setting between January 1, 2016–December 31, 2020. We collected demographic information and used conceptual content analysis to identify the primary ethical issue and contextual features for each consult and analyzed these using descriptive statistics. ResultsWe identified 46 consults (30 adult and 16 pediatric) for 40 unique patients (28 adult and 12 pediatric). The median age was 19 years in the pediatric setting and 24 in the adult setting. Fifty-three percent were female, 95% non-Hispanic, 68% White, and 76% were inpatient. The primary ethical issue in the adult setting was Refusal of Recommended Treatment (20%), while the dominant contextual issue was Communication Disputes/Conflicts Between the Staff and Patient (23%). The primary ethical issue for the pediatric setting was Goals of Care (31%) and the dominant contextual feature was concerns for Quality of Life (31%). DiscussionThe primary ethical issues and related contextual features this population experiences differ based on setting. Improved understanding of adolescent and young adult development, especially related to values formation, decision-making, and communication skills training may ameliorate some of these challenges. Referral patterns for this age group overall and particularly for patients on the ends of the spectrum and inpatients raise concerns for ethics consultation use. Further education about ethics services is recommended.

Evaluating surgeon communication of pancreatic cancer prognosis using the VitalTalk ADAPT framework.

Few data exist to guide optimal communication practices for surgical oncologists. VitalTalk, an evidence-based communication skills training model for clinicians, offers the five-step ADAPT tool for discussing prognosis. This study aimed to characterize surgeon communication of pancreatic cancer prognosis using VitalTalk's ADAPT framework. Contemporaneous audio recordings from 12 initial surgeon-patient encounters for borderline resectable pancreatic cancer were transcribed. Directed qualitative content analysis based on ADAPT (Ask, Discover, Anticipate, Provide, and Track) was used to deductively code transcripts. All encounters contained at least one ADAPT step while only one (8%) incorporated four or five steps. Surgeons provided prognostic information (Provide) in all but one encounter (92%); most was qualitative and clustered into themes: serious illness, surgical candidacy, prognostic ambiguity, and cancer recurrence. Surgeons elicited understanding (Ask), requested information preferences (Discover), anticipated ambivalence (Anticipate), and responded to emotion (Track) in a minority of encounters (25%-42%); of 15 patient emotional cues, six were not addressed by surgeons. During an initial encounter for pancreatic cancer, surgeons focus heavily on providing information but omit critical prognostic communication steps. Future studies are needed to investigate if surgeon training in palliative care-based communicationis feasible and impacts patient-perceived quality of communication.

Addressing the Decline in Clinical Skills: A Call for Comprehensive Educational Reform

Despite technological advances, clinical skills are the foundation of medical practice. Taking a comprehensive clinical history, performing physical examinations, and communicating effectively are crucial for high-quality patient care. Medical students need to focus on developing strong clinical skills to ensure they are well-prepared for their careers and adapt to the evolving field of medicine through continual practice and refinement.1 The medical community is worried about declining essential clinical skills among undergraduate medical students.2,3 This editorial aims to analyze the reasons for the decline and suggest evidence-based methods to address the situation. 05885.0258063. The declining standards of clinical skills among medical students can be attributed to the widespread adoption of technology-based learning, which has the potential to diminish the importance of traditional hands-on bedside teaching.4 Technology should enhance, not replace, practical clinical experiences. Practical training improves the clinical abilities, expertise, and self-assurance of medical students.5 Moreover, the growing magnitude and expansion of medical curricula provide difficulties in the development of educational programs without ample time for bedside practical teaching.6,7 There is frequently an excessive focus on remembering facts rather than on cultivating clinical reasoning abilities.8 The reduced patient interaction during medical school, due to increased reliance on simulations and less time in clinical rotations and bedside teaching, hampers the development of clinical skills.9 External factors such as limited time and extensive paperwork may affect the quality of patient encounters. Efficient communication is crucial for building good relationships with patients, obtaining accurate medical histories, and ensuring patient understanding and adherence to treatment.9 Insufficient training in communication skills can result in less-than-ideal interactions between patients and healthcare providers and can also contribute to errors in diagnosis and medical treatment.10 The provision of trained faculty for teaching medical students is an issue worldwide. Insufficient supervision and feedback during clinical rotations hinder the development of essential clinical skills.11 Larger student cohorts reduce the opportunities for individual students to practice and receive personalized instruction in clinical skills.12 Medical education often prioritizes theoretical testing over practical examinations and undervalues communication skills training. Variability in clinical experiences at different medical schools can lead to inconsistencies in skill acquisition. The scarcity of skilled clinicians as role models impacts students’ learning. Economic constraints and modern healthcare pressures limit opportunities for thorough patient interactions and clinical training.13 THE WAY FORWARD Educational institutions should prioritize hands-on clinical experiences throughout the curriculum to improve students’ diagnostic and communication abilities. These experiences should include simulation-based learning, standardized patients, and longitudinal clerkships. Faculty members need support and resources for effective clinical mentorship and development. Reflective practice should be integrated into the curriculum to enhance self-awareness and critical thinking. Open communication and mentorship programs between students and faculty can strengthen medical training and promote continual learning. To address declining clinical proficiency among medical students, institutions can adopt evidence-based approaches including curriculum changes, faculty training, promoting reflective thinking, collaboration among healthcare professionals, and fostering a culture of ongoing learning. Regulatory bodies should ensure adequate time for bedside teaching and appropriate assessment weightage.

Patient actor training improves preexposure prophylaxis delivery for adolescent girls and young women in Kenya: a cluster randomized trial.

To evaluate effectiveness of a standardized patient actor (SP) training intervention to improve quality of preexposure prophylaxis (PrEP) services for adolescent girls and young women (AGYW) in Kenya. Cluster randomized trial and mystery shopper evaluation. Twelve of 24 maternal child health and family planning facilities were randomized to SP training. Providers at intervention facilities participated in 2-day training in adolescent health, PrEP guidelines, values clarification, and communication skills, followed by role-playing and de-briefing with trained actors. Control facilities received standard national training. The primary outcome was quality of care, assessed by unannounced SPs (USPs) or "mystery shoppers" blinded to intervention arm. Quality was measured in two domains: guideline adherence and communication skills. Intent to treat analysis compared postintervention quality scores by randomization arm, clustering on facility, and adjusting for baseline scores and USP. Overall, 232 providers consented to USP visits, and 94 providers completed the training. Following training, USPs posed as AGYW seeking PrEP in 142 encounters (5-6 encounters per site). The mean quality score was 73.6% at intervention sites and 58.4% at control sites [adjusted mean difference = 15.3, 95% confidence interval (CI): 9.4-21.1, P < 0.001]. Mean guideline adherence scores were 57.2% at intervention sites and 36.2% at control sites (adjusted mean difference = 21.0, 95% CI: 12.5-29.4, P < 0.001). Mean communication scores were 90.0% at intervention sites and 80.5% at control sites (adjusted mean difference = 9.5, 95% CI: 5.5-13.6, P < 0.001). SP training significantly improved quality of PrEP care for AGYW in Kenya. Incorporating SP training and unannounced SP evaluation could improve PrEP uptake among AGYW.

"Training is Everything": How to Prepare Students for Policy Clinic Projects

As more students carry out policy work as part of their law degrees, the different skills needed for policy work have become clearer. Policy work differs from traditional legal studies in a number of key ways, and so requires different, or more developed, skills to effectively participate and engage in projects. This article reviews the literature on the skills required for policy work. It summarises the evaluation of the online training provided to Open University policy clinic students in 2022-23, analysing the attendance and engagement data and the findings of a student survey to draw conclusions about the value and effectiveness of the training. In order for law students to carry out policy work, there is a need for training in policy research and analysis skills and the research suggested students found this of value. Whilst the literature suggested the need for further communication skills training, it was not possible to reach an evidenced conclusion about this from the research. Students expressed a strong preference for online synchronous training sessions provided at the start of a project. The recording of those sessions allowed students to re-visit the training throughout the project as and when needed, which was of value to them.

Feasibility, acceptability, and initial efficacy of empathic communication skills training to reduce lung cancer stigma in Nigeria: a pilot study.

Effective communication about cancer diagnosis and prognosis in sub-Saharan African oncology settings is often challenged by the cancer-related shame and stigma patients and families experience. Enhancing empathic communication between health care providers, including physicians and nurses, and oncology patients and their families can not only reduce cancer stigma but also improve patient engagement, treatment satisfaction, and quality of life. To reduce lung cancer stigma, we adapted an evidence-based empathic communication skills training intervention to reduce patients' experience of stigma in Nigeria and conducted a pilot study examining the feasibility and acceptability of the empathic communication skills training. Thirty health care providers, recruited from University College Hospital, Ibadan, and Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, participated in a 2.25-hour didactic and experiential training session. Participant surveys were completed before and after the training. Overall, participants reported highly favorable training evaluations, with at least 85% of health care providers agreeing or strongly agreeing to survey items assessing training relevance, novelty, clarity, and facilitator effectiveness. Self-efficacy to communicate empathically with patients increased significantly from before-training (Mean [SD] = 3.93 [0.28]) to after-training (Mean [SD] = 4.55 [0.15]; t29 = 3.51, P < .05). Significant improvements were observed in health care provider reports of empathy toward lung cancer survivors and attitude toward lung cancer care as well as significant reductions in lung cancer blame were noted. The empathic communication skills training was feasible, well received by oncology clinicians in Nigeria, and demonstrated improvements in health care provider-reported outcomes from before- to after-training.

인지행동치료 기반 인성교육 프로그램 개발 및 효과

Objectives This study aimed to develop and implement a character education program based on cognitive behav-ioral therapy(CBT) for university students and to verify its effectiveness. Methods This program, grounded in CBT, included psychoeducation, self-monitoring, cognitive restructuring, problem-solving training, and communication skills training. The study subjects were 35 university students ma-joring in child development and education, enrolled in the ‘Childcare Teacher Character Theory’ course offered during the second semester of 2022 at M University. The program was conducted over a total of 29 sessions, each lasting 75 minutes, held twice weekly. The effectiveness of the program was validated through pre- and post-as-sessments, using questionnaires to measure self-esteem, self-efficacy, depression, problem-solving ability, and psychological well-being. Additionally, content analysis was utilized to examine alterations in communication skills, along with specific cognitive, emotional, and behavioral changes among the study subjects. Results The primary findings of this study are as follows. Firstly, significant differences were observed in self-es-teem, self-efficacy, problem-solving ability, and psychological well-being in the pre- and post-program assessments. Specifically, regarding depression, a significant difference was observed in the sub-factor of de-pressive affect. Secondly, the content analysis revealed that post-program implementation, there were seven positive changes observed across cognitive, emotional, and behavioral domains, including improvements in com-munication skills. Conclusions The character education program based on CBT for university students is expected to enhance self-esteem, self-efficacy, communication skills, problem-solving abilities, and psychological well-being, while reducing depressive affect, thus contributing to the cultivation of character. This study is significant in that it has developed and verified the effectiveness of a systematic, evidence-based character education program tailored for university students.

Improving person-centred care for older persons with serious multimorbidity in LMICs.

Few interventions are documented to meet person-centred needs of older people with serious multimorbidity in low- and middle-income countries where access to palliative care is limited. Most of the care in these settings is delivered by primary care health workers. This study reports the development and acceptability testing of a communication skills training and mentorship intervention for primary health care workers in Malawi. This study was conducted at Mangochi District Hospital in the south-eastern region of Malawi. Twelve primary health care workers (four clinical officers and eight nurses) working in the primary care clinics received the intervention. The intervention was designed using modified nominal group technique, informed by stakeholder interviews and a theory of change workshop. Acceptability is reported from thematic analysis of a focus group discussion with primary health care workers who received the intervention using NVivo version 14. Older persons with serious multi-morbidity and their caregivers identified a need for enhanced communication with their healthcare providers. This helped to inform the development of a communication training skills and mentorship intervention package based on the local best practice six-step Ask-Ask-Tell-Ask-Ask-Plan framework. Primary health care workers reported that the intervention supported person-centred communication and improved the quality of holistic assessments, although space, workload and availability of medication limited the implementation of person-centred communication. The Ask-Ask-Tell-Ask-Ask-Plan framework, supported person-centered communication and improved the quality of holistic assessment.Contribution:This intervention offers an affordable, local model for integrating person-centered palliative care in resource-limited primary healthcare settings.

Optimization of Teachers' Verbal Communication Rhetoric in Improving the Quality of Education Services

Objective: This study aims to explore the important role of teachers' verbal communication in improving the quality of educational services and creating a conducive learning environment. Methods: Using a blended research design with a sequential exploratory approach, this study investigates how effective verbal communication from teachers can create interactive and motivating learning environments. Qualitative data from interviews and quantitative data from observations were analyzed to assess the impact of teachers' communication practices. Research Findings and Discussion: This research reveals that effective verbal communication, including stylistic variations and constructive feedback, significantly contributes to student engagement, understanding, and academic achievement. These findings underscore the importance of refining teachers' communication skills to improve the overall quality of education services in the secondary school context. Research Implications: The implication of this research is the need for further attention to teacher verbal communication skills training and development to improve student learning experience and overall quality of educational services. Originality/Value: This study contributes by highlighting the important role of teachers' verbal communication in the context of secondary education, as well as emphasizing the need for attention to the development of teachers' communication skills in order to improve the effectiveness of educational services.

Optimizing Individual HIV Testing and Counseling for Emerging Adult Sexual Minority Men (Aged 18 to 24) in Relationships: A Pilot Randomized Controlled Trial of Adjunct Communication Components.

The majority of new HIV infections in the US occur among sexual minority men (SMM) with older adolescent and emerging adult SMM at the highest risk. Those in relationships face unique HIV prevention challenges. Existing sexual HIV transmission risk interventions for male couples often encounter implementation challenges and engaging younger SMM early in relationships may be particularly difficult. This pilot randomized controlled trial evaluated the acceptibility and feasibility of We Test HIV testing - a behavioral health intervention tailored for younger SMM in realtionships - and generated preliminary estimates of effect size. The intervention comprises two adjunct moduls - video-based communication skills training as well as communication goal setting and planning - delivered in conjunction with routine HIV testing and counseling in individual or dyadic formats. A sample of 69 SMM aged 17 to 24 were recruited online. Following baseline assessment, youth were randomized to receive either the experimental, We Test, intervention or routine HIV testing (the control condition). Follow-up assessments were completed 3 and 6 months post-baseline. Results suggested the study was feasible and the individually delivered format was acceptible. We Test HIV testing was associated with significant improvements in communication skills. In addition, youth who remained in a relationship experienced an increase in communal coping to reduce HIV infection risk and relationship power. While groups did not differ with respect to condomless anal sex with casual partners, these psycho-social constructs (communication, communal coping with HIV prevention, and relationship power) may serve as mediators of intervention effects on sexual risk reduction in a larger study.

Handling conflict situations in psychosis inpatient care: Nursing staff experiences of the Interactive Approach model.

WHAT IS KNOWN ON THE SUBJECT?: In inpatient wards, there is a risk that conflicts occur when nursing staff interact with psychotic patients. The Interactive Approach (IA) model is an action-based model, used in psychiatric settings, to manage conflict situations. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: The IA model can be used to improve communication between nursing staff and patients in numerous critical situations. Using a structured risk scale to evaluate a conflict can be an effective way to guide action and sort out the different aspects of communication between nursing staff and psychotic patients. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The clarity of an action-based model will help sort out which interventions are most likely to succeed in each conflict situation. The IA model highlights the importance of understanding and strengthening the patient's perspective, being flexible for each individual patient, and providing the patient with clear information about the situation. ABSTRACT: Introduction The Interactive Approach (IA) model is a structured management tool used to improve communication between caregivers and patients in psychiatric care settings. Aim/Question To examine the nursing staff's experiences of the IA model. How do they use the interventions in conflict situations with psychotic patients? Method A sample of nursing staff (n = 11) was recruited from three psychosis inpatient care units. Semi-structured questions covered staff experiences of working with the problem-solving interventions in the IA model. Transcribed data were analysed by qualitative content analysis. Results Three categories were defined: (1) 'To apply a flexible approach' describes how staff tried to adapt to each patient and situation; (2) 'Try to understand the person's inner world' describes the importance of active listening and exploring the patient's concerns; and (3) 'To communicate clearly' relates to experiences of clear communication and the setting up of boundaries. Discussion The risk scale and training in communication skills helped the interaction between staff and patients in conflict situations. Different interventions were used with a focus on maintaining patient alliance. Implications for Practice The findings highlight the importance of educational efforts and practical training, to prevent violence and the use of coercive measures.

Bringing competency-based communication training to scale: A multi-institutional virtual simulation-based mastery learning curriculum for Emergency Medicine residents

Purpose Serious illness communication skills are essential for physicians, yet competency-based training is lacking. We address scalability barriers to competency-based communication skills training by assessing the feasibility of a multi-center, virtual simulation-based mastery learning (vSBML) curriculum on breaking bad news (BBN). Methods First-year emergency medicine residents at three academic medical centers participated in the virtual curriculum. Participants completed a pretest with a standardized patient (SP), a workshop with didactics and small group roleplay with SPs, a posttest with an SP, and additional deliberate practice sessions if needed to achieve the minimum passing standard (MPS). Participants were assessed using a previously published BBN assessment tool that included a checklist and scaled items. Authors compared pre- and posttests to evaluate the impact of the curriculum. Results Twenty-eight (90%) of 31 eligible residents completed the curriculum. Eighty-nine percent of participants did not meet the MPS at pretest. Post-intervention, there was a statistically significant improvement in checklist performance (Median= 93% vs. 53%, p < 0.001) and on all scaled items assessing quality of communication. All participants ultimately achieved the MPS. Conclusions A multi-site vSBML curriculum brought all participants to mastery in the core communication skill of BBN and represents a feasible, scalable model to incorporate competency-based communication skills education in a widespread manner.

An Investigation into Student Dietitians’ Professional Development through Video-Mediated Communication Training on Patient Counselling

ABSTRACT The aim of the study is to describe a student dietitian’s professional development process in a video-mediated communication skills training cycle designed for undergraduate nutrition and dietetics education and including activities such as simulated and real patient counseling, feedback, and reflection. The design of the training cycle is inspired by (reflective) interventionist Conversation Analysis (CA) through researcher and trainer collaboration, and the data comes from the screen-recordings of video-mediated meetings. CA is used to analyze the video-mediated interactions on a moment-by-basis and trace the student dietitian’s interactional change over time. CA examination of the data showed that the trainer identified listenership in simulated sessions as an improvable practice (i.e. due to repetitive overlaps and cutoffs) and used it as the basis for the intervention. In the post-intervention period, the student dietitian observably improved her listenership both in simulated and real patient counseling sessions. The video-mediated, interventionist, reflective, and data-led cycle played a role in the development of the interactional and professional practice of the student dietitian in ways transferrable to real patient counseling. The training cycle with evidence-based lectures, data-led interventions, and simulated/real patient counseling can be integrated to dietetics education curricula both for clinical communication training and preparing for future teleconsultation practices.

Virtual Reality as a Tool for Training Communication Skills in Higher Education Students

Objective: To explore the use of virtual reality in the development of communicative skills in this specific demographic group. Relevant research examining both the effectiveness and practical applications of virtual reality in communication training programs within higher education institutions is reviewed in detail. Methods: The study focused on the systematic literature review of the use of virtual reality in developing communication skills among university students. A comprehensive search was conducted in academic databases using specific keywords, and strict inclusion and exclusion criteria were applied to select relevant studies. A detailed analysis of the extracted data was performed, highlighting key findings and conclusions, and the methodological quality of the included studies was evaluated. The results emphasized both the benefits and limitations of virtual reality in this context, and the potential limitations of the study were acknowledged, emphasizing the need for further research to strengthen the evidence in this area. Result: A documentary matrix was developed to analyze the impact of virtual reality on the teaching of social sciences in elementary education, selecting approximately fifteen scientific articles from academic databases. Each article was meticulously reviewed to extract relevant data on the study objectives, methodologies, results, and conclusions. This matrix enables a systematic and structured review of the existing knowledge in this emerging area, providing a deeper understanding of the benefits and challenges associated with the implementation of virtual reality in the teaching of social studies in elementary education.

Early Communication Skills Training for Infants and Toddlers with Cochlear ImplantEarly Communication Skills Training for Infants and Toddlers with Cochlear Implant

Background and Aim: Early communication skills in children with hearing loss depend on the quantity and quality of information received from parents. The present study aimed to investigate the effectiveness of early communication skills training in developing the communication skills of infants and toddlers with cochlear implants. Methods: To this end, 54 infants and toddlers at the age range of 8–24 months with sever to profound hearing loss fitted by Cochlear Implant (CI) with their mothers participated in this study. The experimental and wait list control groups had auditory verbal therapy as the main intervention after the CI; however, the experimental group received a systematic early communication skills program. All subjects were assessed using the Communication and Symbolic Behaviour Scales Developmental Profile as the pre-and post-tests. Results: Multivariate analysis of covariance indicated the effect of systematic training on the early communication development of subjects in intervention group. Conclusion: Teaching the parents how to interact with infants and toddlers with CI could improve the communication skills of the infants and therefore it’s recommended to be included in the auditory rehabilitation programs.

Acquisition of key clinical communication skills through simulation-based education: findings from a program for postgraduate psychiatry trainees (ComPsych)

ObjectiveFew studies have investigated the maintenance of skills acquired in classroom-based clinician education. Using an advanced simulation-based clinical communication skill training program for postgraduate psychiatry education (ComPsych), we aimed to investigate skill acquisition through assessing changes in competence (abilities) and performance (practice).MethodsForty trainee psychiatrists (15 males; age range 26–48) participated. Video-recorded Standardized Patient Assessments (SPAs) were delivered twice pre- and post-training to assess learning. Skills were coded by independent psychologists using the Core Communication Skills (CCS) coding system. Simulated patients (SPs) rated trainees' communication performance using the Sim-Patient SPA checklist. Paired t-tests, linear mixed models and logistic mixed models assessed changes in communication skills over time.ResultsFor SPAs, reliability of coder ratings was deemed acceptable (ICC range 0.67 to 0.87). Mean post-training communication performance significantly increased for skills in agenda setting (p < 0.001), information organization (p < 0.001), empathic skills (p = 0.046), and overall skills performance (p = 0.001). Significant decreases for questioning skills were indicative of reduced reliance on these skills post-training. SPs rated all skillsets higher post-training. A modest relationship was detected between frequency (coded) and (SP-rated) quality of communication skills. Improvements in agenda setting and information organisation skills were retained ~ 6 weeks post-training.ConclusionsTraining improved patient-centered communication skills in psychiatry trainees, particularly skills in agenda setting and information organization, with skills retained ~ 6 weeks post-training. There was reduced reliance on questioning skills, which are well utilised generally. The study supports the benefits of this method of communication skills training into postgraduate psychiatry education.

Reducing Undue Burden on Nurses Related to Limited Care Partner Visitation: Lessons Learned for the Future.

The purpose of this article was to report best practices for reducing undue burden on nurses related to limited care partner visitation. Care partners are beneficial to hospitalized patients. Restricted care partner visitation not only impacts patients and care partners but also affects nurses. Using the Johns Hopkins Evidence-Based Practice model, best practices for reducing nurse burden during periods of restricted visitation were evaluated. Best practices include evidence-based visiting policies, technology to facilitate communication, creation of a communication liaison role or team, and communication skills training for nurses. Nursing leaders should proactively prevent the harmful impact that visitor restrictions have on nurses.

Effects of on-site Supportive Communication Training (On-site SCT) on doctor-patient communication in oncology: Study protocol of a randomized, controlled mixed-methods trial

BackgroundThe quality of communication in oncology significantly impacts patients' health outcomes, as poor communication increases the risk of unnecessary treatment, inadequate pain relief, higher anxiety levels, and acute hospitalizations. Additionally, ineffective communication skills training (CST) is associated with stress, low job satisfaction, and burnout among doctors working in oncology. While acknowledging the importance of effective communication, the specific features of successful CST remain uncertain. Role-play and recorded consultations with direct feedback appear promising for CST but may be time-consuming and face challenges in transferring acquired skills to clinical contexts. Our aim is to bridge this gap by proposing a novel approach: On-site Supportive Communication Training (On-site SCT). The concept integrates knowledge from previous studies but represents the first randomized controlled trial employing actual doctor-patient interactions during CST.MethodsThis randomized multicenter trial is conducted at three departments of oncology in Denmark. Doctors are randomized 1:1 to the intervention and control groups. The intervention group involves participation in three full days of On-site SCT facilitated by a trained psychologist. On-site SCT focuses on imparting communication techniques, establishing a reflective learning environment, and offering emotional support with a compassionate mindset. The primary endpoint is the change in percentage of items rated “excellent” by the patients in the validated 15-item questionnaire Communication Assessment Tool. The secondary endpoints are changes in doctors’ ratings of self-efficacy in health communication, burnout, and job satisfaction measured by validated questionnaires. Qualitative interviews will be conducted with the doctors after the intervention to evaluate its relevance, feasibility, and working mechanisms. Doctors have been actively recruited during summer/autumn 2023. Baseline questionnaires from patients have been collected. Recruitment of new patients for evaluation questionnaires is scheduled for Q1-Q2 2024.DiscussionThis trial aims to quantify On-site SCT efficacy. If it significantly impacts patients/doctors, it can be a scalable CST concept for clinical practice. Additionally, qualitative interviews will reveal doctors' insight into the most comprehensible curriculum parts.Trial registrationApril 2023 – ClinicalTrials.gov (NCT05842083). April 2023 – The Research Ethics Committee at the University of Southern Denmark (23/19397).

Effects of C-reactive protein rapid testing and communication skills training on antibiotic prescribing for acute cough. A cluster factorial randomised controlled trial

This cluster randomised clinical trial carried out in 20 primary care centres in Barcelona was aimed at assessing the effect of a continuous intervention focused on C-reactive protein (CRP) rapid testing and training in enhanced communication skills (ECS) on antibiotic consumption for adults with acute cough due to lower respiratory tract infection (LRTI). The interventions consisted of general practitioners and nurses’ use of CRP point-of-care and training in ECS separately and combined, and usual care. The primary outcomes were antibiotic consumption and variation of the quality-adjusted life years during a 6-week follow-up. The difference in the overall antibiotic prescribing between the winter seasons before and after the intervention was calculated. The sample size calculated could not be reached due to the COVID-19 outbreak. A total of 233 patients were recruited. Compared to the usual care group (56.7%) antibiotic consumption among patients assigned to professionals in the ECS group was significantly lower (33.9%, adjusted odds ratio [aOR] 0.38, 95% CI 0.15–0.94, p = 0.037), whereas patients assigned to CRP consumed 43.8% of antibiotics (aOR 0.70, 95% CI 0.29–1.68, p = 0.429) and 38.4% in the combined intervention group (aOR 0.45, 95% CI, 0.17–1.21; p = 0.112). The overall antibiotic prescribing rates in the centres receiving training were lower after the intervention compared to those assigned to usual care, with significant reductions in β-lactam rates. Patient recovery was similar in all groups. Despite the limited power due to the low number of patients included, we observed that continuous training achieved reductions in antibiotic consumption.