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 (t(141)=-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.