Patient-Clinician Communication: American Society of Clinical Oncology Consensus Guideline Summary

Gilligan, Timothy D.; Bohlke, Kari

doi:10.1200/jop.2017.027144

Cited by 47 publications

(41 citation statements)

References 7 publications

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“…Despite the challenges of research on quality of communication, the evidence of low clinician competence and the evidence that training is efficacious have led to a consensus of professional clinician and policy‐making organizations, led by the National Academy of Sciences, for widespread and mandatory communication skills training. A 2017 guideline published by the American Society of Clinical Oncology (ASCO), in addition, concluded that communication training should be provided to every oncologist and trainee. These recommendations and guidelines could reasonably be applied to every health professional involved in caring for the seriously ill.…”

Section: Evidence‐based Training Changes Communication Behaviors and mentioning

confidence: 99%

“…The ASCO published communication guidelines in 2017 that specifically addressed how clinicians should acquire communication skills . The ASCO guidelines note that “communication skills training should be based upon sound educational principles and include and emphasize skills practice and experiential learning using role‐play scenarios, direct observation of patient encounters, and other validated techniques.” Second, training “should foster practitioner self‐awareness and situational awareness related to emotions, attitudes and underlying beliefs that may affect communication.” Third, “facilitators of communication skills training should have sufficient training and experience” because distinctive pedagogical knowledge is required.…”

Section: Existing Recommendations and Barriers To Their Implementationmentioning

confidence: 99%

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Training Clinicians with Communication Skills Needed to Match Medical Treatments to Patient Values

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Fromme

Meier

2019

J American Geriatrics Society

125

111

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Most clinicians currently in practice did not receive the evidence-based communication skills training they need to provide high-quality communication for seriously ill older adults and their families. Clinician communication skills are a critical factor in achieving a patient and family understanding of their illness that enables them to share in decision making that will result in medical treatments and social supports that are aligned with their goals and values. Research demonstrates that existing clinician competence in communication skills is extremely variable, that most clinicians need specific communication training to have an adequate level of skill, and that evidence-based training is efficacious. A conservative estimate suggests that more than 219,000 physicians and advance practice providers (APPs) (50% of physicians in high-contact subspecialties and 25% of all APPs) could benefit from training. Combining evidence-based clinician training with health system workflow redesign would likely maximize the impact of this training. We conclude with recommendations designed to address gaps in communication skills through effective training and health system changes in the service of enabling all patients with serious illness and their families to receive care aligned with their personal priorities. J Am Geriatr Soc 67:S435-S441, 2019.

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Section: Evidence‐based Training Changes Communication Behaviors and mentioning

confidence: 99%

Section: Existing Recommendations and Barriers To Their Implementationmentioning

confidence: 99%

Training Clinicians with Communication Skills Needed to Match Medical Treatments to Patient Values

Back

Fromme

Meier

2019

J American Geriatrics Society

125

111

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“…Nevertheless, strategies to support patient-clinician communication are important, but often missing elements of self-management education for patients with cancer [11]. Recent evidence surrounding the use of patient question prompt lists [21], individualized clinician communication training [22], and recommendations from patient-clinician communication clinical practice guidelines [23] may be used to guide the integration of communication coaching strategies into self-management interventions that target both patients and clinicians.…”

Section: Discussionmentioning

confidence: 99%

“…Differences in participant adherence to clinician recommendations was a crucial factor in self-reported ratings of symptom management satisfaction and symptom distress. Clinicians must use effective communication (eg, establish goals for care and conversations with patients, gain insight surrounding patient’s understanding of their condition, check for patient’s understanding of information provided) [23] and spend sufficient time with the patient to vigilantly assess patients’ self-reported symptoms as the most severe symptoms may not be the most bothersome. In addition, effective patient-clinician communication about symptom management may increase patient adherence to clinician recommendations.…”

Section: Discussionmentioning

confidence: 99%

Impact of Electronic Self-Assessment and Self-Care Technology on Adherence to Clinician Recommendations and Self-Management Activity for Cancer Treatment–Related Symptoms: Secondary Analysis of a Randomized Controlled Trial

Knoerl¹,

Hong²,

Blonquist³

et al. 2019

JMIR Cancer

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BackgroundPatients undergoing cancer treatment experience symptoms that negatively affect their quality of life and adherence to treatment. The early identification and management of treatment-related symptoms are critical to prevent symptom distress due to unmanaged symptoms. However, the early identification and management of treatment-related symptoms are complex as most cancer treatments are delivered on an outpatient basis where patients are granted less face-to-face time with clinicians. The Electronic Symptom Assessment and Self-Care (ESRA-C) promotes participant self-management of treatment-related symptoms by providing participants with communication coaching and symptom self-report, education, and tracking features. While the ESRA-C intervention has been demonstrated to improve symptom distress significantly, little is known as to how the ESRA-C influenced participants’ self-management practices and adherence to clinician recommendations for symptom/quality of life issues (SQIs).ObjectiveTo compare participant adherence to clinician recommendations and additional self-management strategy use for SQIs between ESRA-C intervention and control (electronic symptom assessment and participant symptom reports alone) group participants. Secondarily, we explored the impact of participant adherence to clinician recommendations and additional self-management strategy use for SQIs on symptom control, symptom management satisfaction, and symptom distress. Lastly, we examined baseline predictors of participant adherence to clinician recommendations and additional self-management strategy use for SQIs.MethodsThis study presents an analysis of a randomized controlled trial. Participants beginning a new chemotherapy or radiotherapy regimen were recruited from oncology outpatient centers and were randomized to receive the ESRA-C intervention or control during treatment. Patients were included in this analysis if they remained on study through the duration of treatment and self-reported at least one bothersome SQI three-to-six weeks after beginning treatment. The Symptom Distress Scale-15 and Self-Management of SQIs Questionnaire were completed two weeks later. Based on Self-Management of SQIs Questionnaire ratings, participants were placed into adherence to clinician recommendations (adhered/did not adhere/did not receive recommendations) and additional self-management strategy use (yes/no) categories.ResultsMost participants were adherent to clinician recommendations (273/370, 73.8%), while fewer used additional self-management strategies for SQIs (182/370, 49.2%). There were no differences in the frequency of participant adherence to clinician recommendations (chi-square test, P=.99) or self-management strategy use (chi-square test, P=.80) between intervention (n=182) and control treatment groups (n=188). Participants who received clinician recommendations reported the highest treatment satisfaction (n=355, P<.001 by analysis of variance; ANOVA), although lowest distress was reported by participants who did not follow cl...

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“…5 More recently, a systematic review by the American Society of Clinical Oncology (with Walter F. Baile as the senior author) was published with more specific recommendations for communication training. 6 Recommendations 9.1 and 9.2 are as follows:…”

Section: Introductionmentioning

confidence: 99%

Delivering Challenging News: An Illness-Trajectory Communication Curriculum for Multispecialty Oncology Residents and Fellows

et al. 2019

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Introduction Published curricula to teach communication skills for postgraduate fellows in oncology are few in number despite the fact that oncologists conduct many difficult discussions with their patients and their families. Such discussions may include disclosing initial diagnosis or relapse of a patient's cancer or relaying a poor prognosis or change to palliative care. Methods An eight-module course on communication in oncology practice was delivered over 2 months for palliative and oncology fellows and radiation oncology residents. Learners were given a precourse survey in which they were asked to rate their proficiency in various communication tasks. Each learner then participated in a videotaped precourse objective structured clinical exam (OSCE) on breaking bad news with standardized patients (SPs). The course took place over 8 weeks with weekly didactics and role-play. At the end of the course, a second OSCE took place. After the course was completed, the fellows again filled out a proficiency survey. Results Twenty-two learners participated over 2 years of this course. Participants reported a significant increase in perceived competence in all areas on the postcourse survey. SP feedback on OSCEs pre- and postcourse indicated improvement in skills for learners. Pre- and postcourse OSCE video assessment revealed a significant improvement in global communication skills. Discussion Initial data show that this course successfully improved communication skills and increased fellows' comfort level across several domains of communication. Future directions include validating our assessment tool, expanding the topic base, and investigating the impact on practice after course completion.

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Patient-Clinician Communication: American Society of Clinical Oncology Consensus Guideline Summary

Cited by 47 publications

References 7 publications

Training Clinicians with Communication Skills Needed to Match Medical Treatments to Patient Values

Training Clinicians with Communication Skills Needed to Match Medical Treatments to Patient Values

Impact of Electronic Self-Assessment and Self-Care Technology on Adherence to Clinician Recommendations and Self-Management Activity for Cancer Treatment–Related Symptoms: Secondary Analysis of a Randomized Controlled Trial

Delivering Challenging News: An Illness-Trajectory Communication Curriculum for Multispecialty Oncology Residents and Fellows

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