Improving Awareness of the Psychosocial Needs of the Patienta Training Course for Experienced Cancer Doctors

Abstract

There is substantial evidence of psychic morbidity among cancer patients (1)(2)(3)(4). Much of this morbidity is a reaction to the overwhelming stress induced by the awareness of cancer disease (5, 6). The morbidity can, however, be reduced by psychosocial intervention (7) where the doctor-patient relationship plays an important role (8). A prerequisite is that those who care for cancer patients have some knowledge of the psychological stress reactions and are trained in dealing with it. Today, elementary "medical psychology" and psychosocial skills are taught at most medical schools, but the majority of doctors who are responsible for the treatment of cancer patients have not had such training either as students or later in their professional life. In order to redress this lack of knowledge and training, the Nordic Cancer Union decided in 1992 to sponsor the development of a short but efficient training course for cancer doctors at the consultant level.Aim of the course. The aim of the course was to effect a change of doctors' attitudes as well as conduct. On completion of the course the participants were expected to have increased their psychological knowledge and to have improved their skills in identifying and dealing with difficult situations involving cancer patients.Description of the course. The course covered a period of five months. Participants were divided into groups comprising six doctors and one teacher/tutor, all of whom resided within commuting distance of one another in order to make it possible to meet at the end of a working day.The course began with three seminars, each lasting three hours and conducted at two-week intervals. They were teacher-led and structured around interviewing skills, psychological crisis reactions and psychological defence mechanisms. Before each seminar, material for self-studies was distributed. Educational videotapes, prepared beforehand, were used to illustrate the various subjects.The seminars were followed by a boarding course lasting three days when all the groups and their teachers met. The teachersltutors continued to work with their own group. This made it possible for the teachers to meet at the end of each day. A special supervisor provided the teachers/tutors with daily feedback on their group work and on the group process. Role-play in the small groups was used as described by Maguire & Faulkner (9), complemented with a list of lecture themes.Each small group began by deciding on their areas of interest.The most common were: How to convey ominous or upsetting information; how t o deal with denial; how to set limits on demands from patients; how to deal with incurable patients; how to cope with aggression and anxiety. Other important topics were: Contact with the patient's family and how to collaborate with disagreeing colleagues. Problems with feelings of one's own inadequacy, lack of time to do a proper job and "alternative medicine" were also on the agenda. These topics were then worked through in the role-play. Cognitive and emotional issues were also d...

Pedagogical methods and affect tolerance in medical students

“…The test has also been used before and after courses in interview skills and empathy training. Results from these confirm the validity of the test 13 , 14 …”

Long term benefits of communication skills training for cancer doctors

“…The Nordic Cancer Union decided to develop a training programme in communication skills training for senior cancer doctors from the Nordic countries, which was started in 1992. Short-term evaluation of the first course in the programme has been published (Aspegren et al, 1996).…”

Ways of understanding the encounter with head and neck cancer patients in the hospital dental team—a phenomenographic study

“…As part of the treatment team, dental staff must not only take into consideration the patients' medical predicament, but they must also have the ability to respond to the patients' psychological distress. Whilst training in communication skills is available for medical and caring professionals [3,14], dental personnel are more or less on their own, without specific training and supervision.…”