A consultation training program for physicians for communication about complementary medicine with breast cancer patients: a prospective, multi-center, cluster-randomized, mixed-method pilot study

Abstract

BackgroundThe aim was to develop and evaluate a training program for physicians for communicating with breast cancer patients about complementary medicine (CM).MethodsIn a cluster-randomized pilot trial eight breast cancer centers (two physicians per center) were randomized to either a complementary communication training program (9 h e-learning + 20 h on-site skills training) or to a control group without training. Each physician was asked to consult ten patients for whom he or she is not the physician in charge. We used mixed methods: Quantitative outcomes included physicians’ assessments (empathy, complexity of consultation, knowledge transfer) and patients’ assessments (satisfaction, empathy, knowledge transfer). For qualitative analyses, 15 (eight in the training and seven in the control group) videotaped consultations were analyzed based on grounded theory, and separate focus groups with the physicians of both groups were conducted.ResultsA total of 137 patients were included. Although cluster-randomized, physicians in the two groups differed. Those in the training group were younger (33.4 ± 8.9 vs. 40.0 ± 8.5 years) and had less work experience (5.4 ± 8.9 vs. 11.1 ± 7.4 years). Patient satisfaction with the CM consultation was relatively high on a scale from 0 to 24 and was comparable in the two groups (training group: 19.4 ± 4.6; control group 20.5 ± 4.1). The qualitative findings showed that physicians structured majority of consultations as taught during the training. Comparing only the younger and less CM experienced physicians, those trained in CM communication felt more confident discussing CM-related topics than those without training.ConclusionA CM communication-training program might be especially beneficial for physicians with less consulting experience when communicating about CM-related issues. A larger trial using more suitable quantitative outcomes needs to confirm this.Trial registrationClinicalTrials.gov: NCT02223091, date of registration: 7 February 2014.

Gynecologic oncologists’ attitudes and practices relating to integrative medicine: results of a nationwide AGO survey

“…This finding is consistent with the report by Muecke et al, who showed that education and training are the most essential requirements for physicians to enable them to implement CAM methods [17]. Other national and international studies have also confirmed the finding that there is generally a high level of interest in integrative therapy approaches amongst physicians, but that specific training in CAM methods is lacking [17–22]. Comparison with existing data is difficult, as the studies are not mainly aimed at oncologists, but rather at physicians in general, so that the groups of patients involved differ.…”

Addressing Unmet Information Needs: Results of a Clinician-Led Consultation Service About Complementary and Alternative Medicine for Cancer Patients and Their Relatives

“… 49 , 50 We acknowledge that there is evidence that not only the topics of a consultation, but also its perceived duration is a determinant of patient satisfaction. 51 , 52 …”

“…Our data have been used in the ongoing collaborative research project KOKON ( http://www.kompetenznetz-kokon.de ) for the development of information and training programs for clinicians 26 , 52 and of a multicenter consultation service about CAM at comprehensive cancer centers with physicians coming from different medical specialties (publication in preparation).…”

Training oncology physicians to advise their patients on complementary and integrative medicine: An implementation study for a manual‐guided consultation

“…With the goal of translating evidence‐based knowledge into clinical practice, implementation science addresses these issues by translating scientific findings into practical application 21 . Our previous cluster‐randomized study showed that oncology physicians who had little experience in discussing CIM gained the most benefit from CIM training 22 . However, this training used the conceptual approach that patients would receive CIM information from an oncology physician who was not their cancer‐treating physician.…”