Discussing prognosis in an oncology setting: initial evaluation of a communication skills training module



Objective: Although cancer patients from Western countries have high needs for prognostic information, the frequency of such discussions in oncology consultations is variable. Prognosis is a difficult discussion area for both physicians and patients. Physician focused Communication Skills Training (CST) has been suggested as a means to aid these discussions. We developed and tested a CST module about discussing prognosis. Training consisted of didactic teaching, exemplary video and role-play sessions. The study aim was to develop the module and evaluate the effectiveness of the training.

Method: One hundred and forty-two clinicians from Memorial Sloan-Kettering Cancer Center and the New York City area voluntarily participated in the training module over a two-year period. The module was based on current literature and followed the Comskil model previously utilized for other doctor–patient CSTs. Participants completed pre and post surveys to evaluate their own confidence as well as the helpfulness of the module.

Results: Based on a retrospective pre–post measure, participants reported an increase in their confidence about discussing prognosis (t141=−9.331, p<0.001). At least 92% of participants reported their satisfaction with components of the module by either agreeing or strongly agreeing with 5/6 different statements included in their evaluation forms.

Conclusions: This short training program demonstrated success in improving physician confidence to discuss prognosis and self-efficacy. This result, coupled with the participant's intent to utilize new skills in clinical encounters, suggests that this is a useful module. Future research will target changes in patient outcomes as a result of the physician training. Copyright © 2009 John Wiley & Sons, Ltd.