This brief report aims to highlight the impact of globalization – the international movement of goods, people, and ideas – on patient-provider communication in medical training and practice, and how the implementation of plain language communication training as a core competency for care providers can mitigate this impact. Globalization influences both patient and provider population diversity, which presents challenges with regard to patient-provider communication, particularly in cases of limited health literacy. Plain language communication - the delivery of information in a simple, succinct, and accurate manner - can help address these challenges. Training in plain language communication, however, is not a part of standard education for health care providers. Based on a synthesis of relevant literature pertaining to globalization, plain language communication, and medical education curricula, it is hoped that the information presented establishes the need for plain language communication as a core competency in medical education to enable providers to better meet the needs of an increasingly globalized health system.

Background: Quitting smoking after a cancer diagnosis minimizes treatment-related effects, improves prognosis, and enhances quality of life. However, smoking cessation services are not routinely integrated into cancer care. The Princess Margaret Cancer Centre implemented a digitally based Smoking Cessation Program (SCP) in oncology, leveraging an e-referral system (CEASE), to screen all new ambulatory patients, provide tailored education and advice on quitting, and facilitate referrals. Methods: We adopted the Framework for Managing eHealth Change to guide implementation of the SCP by integrating six key elements: 1) Governance and leadership; 2) Stakeholder engagement; 3) Communication; 4) Work flow analysis and integration; 5) Monitoring and evaluation; and 6) Training and education.Results:  Incorporating elements of the Framework, we established a SCP with organizational and provincial accountability, through extensive stakeholder engagement and strategic partnerships. CEASE was integrated into existing electronic patient reported assessments. Clinic audits and staff engagement allowed for analysis of work flow, ongoing monitoring and evaluation aided in establishing a communication strategy and development of cancer-specific patient and healthcare provider education. From April 2016 to March 2018, 22,137 new patients were eligible for screening. Among those, 13,617 (62%) new patients were screened; 1,382 (10%) current smokers and 532 (4%) who recently quit within 6 months. Among those smokers or recently quit, all were advised to quit; 380 (20%) accepted referral to a smoking cessation counseling service.Conclusions: This paper provides a comprehensive practice blueprint to implement digitally based SCPs as a standard of care within comprehensive cancer centers with high patient volumes.

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BACKGROUND:The coronavirus disease 2019 (COVID-19) pandemic has caused enormous strain on public health. Patients with cancer are particularly susceptible to the disease, and their treatment plans have been threatened by public health restrictions designed to contain the spread. METHODS: This study examined the effects of the pandemic on cancer patients' psychology, knowledge, attitudes, and practices concerning COVID-19 as well as their perceptions of the impact of COVID-19 on their cancer health care services. A survey was sent to 5800 patients at a cancer center in Toronto, Canada. Descriptive results were summarized. Qualitative feedback was coded and summarized. To examine for potential associations, regression models were tested for the outcomes of patient psychological well-being, knowledge, attitudes, and practices, and they accounted for several demographic, health literacy, and disease variables. RESULTS: A total of 1631 surveys were completed. Most patients saw their appointments shifted to virtual visits, and for a substantial minority, there was no change. A majority of the patients (62%) expressed fears about contracting the virus. There were no independent predictors of COVID-19-related knowledge. Fears were more pronounced among patients who did not speak English and those who used social media more often. Female participants, those who scored higher on knowledge questions, and those who used cancer center materials were more likely to take preventative measures against infection. CONCLUSIONS: This study provides a snapshot of the state of cancer patient treatment and the knowledge, attitudes, and practices of patients between the first 2 waves of the pandemic. The study's results can inform our understanding of adaptation to conditions during and after the outbreak.

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The Internet is widely used for accessing COVID-19 information and while abundant, it is frequently complex, inconsistent, and contradictory. This "misinfodemic" has repeatedly revealed low health literacy to be an underestimated public health problem. This study evaluated whether this holds true for information about COVID-19 and cancer on commonly visited websites. "Coronavirus and cancer" and "COVID-19 and cancer" were entered in Google Canada and the first 10 results were evaluated for readability, understandability, actionability, accuracy and consistency. Much of the cancer and COVID-19 information online does not meet health literacy best practices and is inaccessible to patients seeking this information.

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Patient educators come into the field from diverse professional backgrounds and often lack training in how to teach and develop patient education resources since no formal patient education professional certification program exists. A professional certification program for patient educators would further define the professional scope of practice and reduce variability in performance. The purpose of this study was to (1) determine the level of interest among Canadian cancer patient educators in a patient education professional certification program and (2) determine the competencies to be included in the professional certification program. A 12-item survey was designed by executive members of the Canadian Chapter of the Cancer Patient Education Network. The survey included a list of competencies associated with patient education, and a 4-point Likert scale ranging from "slightly important" to "very important" was used to determine the rank of each competency. The survey was sent to 53 patient educators across Canada. Ninety-two percent of the patient educators are interested in a professional certification program. Patient educators indicated that competencies related to developing patient resources, collaboration, plain language expertise, and health literacy were of most importance. Patient educators support the development of a patient education professional certification program and endorsed the competencies proposed. This information provides the foundation for the creation of a professional certification program for cancer patient educators.