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Development and preliminary evaluation of communication skills training program for oncologists based on patient preferences for communicating bad news

Published online by Cambridge University Press:  04 November 2013

Maiko Fujimori ,
Yuki Shirai ,
Mariko Asai ,
Nobuya Akizuki ,
Noriyuki Katsumata ,
Kaoru Kubota  and
Yosuke Uchitomi
Maiko Fujimori
Affiliation:
Psycho-Oncology Division, Research Center for Innovative Oncology, National Cancer Center Hospital East, Kashiwa, Chiba, Japan Psycho-Oncology Division, National Cancer Center Hospital, Chuoh-ku, Tokyo, Japan
Yuki Shirai
Affiliation:
Psycho-Oncology Division, Research Center for Innovative Oncology, National Cancer Center Hospital East, Kashiwa, Chiba, Japan Department of Adult Nursing and Palliative Care Nursing, University of Tokyo, Bunkyo-ku, Tokyo, Japan
Mariko Asai
Affiliation:
Graduate School of Clinical Psychology, Teikyo Heisei University, Toshima-ku, Tokyo, Japan
Nobuya Akizuki
Affiliation:
Department of Psycho-oncology, Chiba Cancer Center, Chuo-ku, Chiba, Japan
Noriyuki Katsumata
Affiliation:
Department of Medical Oncology, Nippon Medical School, Musashikosugi Hospital, Nakahara-ku, Kawasaki, Kanagawa, Japan
Kaoru Kubota
Affiliation:
Medical Oncology Division, Nippon Medical School Hospital, Bunkyo-ku, Tokyo, Japan
Yosuke Uchitomi*
Affiliation:
Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Kita-ku, Okayama, Japan
*
Address correspondence and reprint requests to: Yosuke Uchitomi, Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan. E-mail: [email protected]
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Abstract

Objective:

The purposes of this study were to develop a communication skills training (CST) workshop program based on patient preferences, and to evaluate preliminary feasibility of the CST program on the objective performances of physicians and the subjective ratings of their confidence about the communication with patients at the pre- and post-CST.

Methods:

The CST program was developed, based on the previous surveys on patient preferences (setting up the supporting environment of the interview, making consideration for how to deliver bad news, discussing about additional information, and provision of reassurance and emotional support) and addressing the patient's emotion with empathic responses, and stressing the oncologists' emotional support. The program was participants' centered approach, consisted a didactic lecture, role plays with simulated patients, discussions and an ice-breaking; a total of 2-days. To evaluate feasibility of the newly developed CST program, oncologists who participated it were assessed their communication performances (behaviors and utterances) during simulated consultation at the pre- and post-CST. Participants also rated their confidence communicating with patients at the pre-, post-, and 3-months after CST, burnout at pre and 3 months after CST, and the helpfulness of the program at post-CST.

Results:

Sixteen oncologists attended a newly developed CST. A comparison of pre-post measures showed improvement of oncologists' communication performances, especially skills of emotional support and consideration for how to deliver information. Their confidence in communicating bad news was rated higher score at post-CST than at pre-CST and was persisted at 3-months after the CST. Emotional exhaustion scores decreased at 3-months after CST. In addition, oncologists rated high satisfaction with all components of the program.

Significance of results:

This pilot study suggests that the newly developed CST program based on patient preferences seemed feasible and potentially effective on improving oncologists' communication behaviors what patients prefer and confidence in communicating with patients.

Keywords

Communication skills trainingPatients' preferenceBad newsPatient-physician relationship
Type
Original Articles
Information
Palliative & Supportive Care , Volume 12 , Issue 5 , October 2014 , pp. 379 - 386
Copyright
Copyright © Cambridge University Press 2013 

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