Communication Skills Education Program for Oncology

肿瘤学沟通技巧教育计划

• 批准号: 8249466
• 负责人: Carma L. Bylund
• 金额: $ 32.4万
• 依托单位: SLOAN-KETTERING INST CAN RESEARCH
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-05-01 至 2015-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8249466
• 关键词: Adverse effects; Cancer Education Grant Program; Caring; Childhood; Clinic; Clinical; Communication; Competence; Complex; Comprehensive Cancer Center; Consultations; Development; Dose; Education; Educational Curriculum; Educational process of instructing; Effectiveness; Emotional; Ensure; Evaluation; Faculty; Family; Feedback; Foundations; Goals; Intervention; Learning; Medical; Medical Oncology; Memorial Sloan-Kettering Cancer Center; Oncologist; Operative Surgical Procedures; Outcome; Participant; Patient Outcomes Assessments; Patients; Perception; Performance; Physicians; Process; Program Development; Radiation Oncology; Reaction; Research; Risk; Self Assessment; Self Efficacy; Surgical Oncology; Testing; Training; Work; improved; oncology; oncology program; outcome forecast; palliative; programs; psychological distress; public health relevance; response; skills; skills training; uptake

DESCRIPTION (provided by applicant): Effective communication between physician and patient is the foundation of quality medical care. In the oncology setting, physician-patient communication is particularly important because oncologists discuss difficult issues with patients. These conversations typically include discussing prognosis, ensuring patient and family understand the prominent risks and side-effects of treatments, assessing and responding to psychological distress, managing the transition of care from a curative to palliative goal, and working to accept the dying process. Research suggests that oncologists, particularly newly trained oncologists, receive little training in how to communicate effectively about such issues. As a result, patients have unmet informational and emotional needs and their adaptation across the course of care is influenced by the interaction with and support they receive from the clinician. Over the course of the last decade, interventions to improve communication skill and efficacy have been developed and tested in RCTs, and have proven efficacy in altering physician communication. The establishment of programs of advanced communication skills training at Comprehensive Cancer Centers is a key training need for oncology nationally. This application responds to this need with a careful examination of an educational program piloted at Memorial Sloan-Kettering Cancer Center. The overall goal of this proposal is to develop a Communication Skills Education Program for Oncology. This program will be supported through three cores: an Education Core, a Faculty Development and Training Core, and an Evaluation Core. The specific aims of this proposal are: Aim 1: To implement through an Education Core a communication training curriculum for Comprehensive Cancer Centers to improve the ability of medical, surgical, and pediatric fellows and junior faculty to communicate with patients and families effectively about complex oncological issues; Aim 2: To support this communication training curriculum through a Faculty Development and Training Core. This training core will maintain a faculty development program for attending physicians and will offer continuing training and feedback to facilitators to better teach communication skills; Aim 3: To assess through an Evaluation Core the outcomes of these programs on fellows and junior faculty through examination at several levels including: self-assessment, performance in standardized patient assessments, performance in clinical encounters, and patient reported outcomes. In this proposal, we will demonstrate the efficacy of a 7-module educational program on 264 participants and evaluate its effectiveness through the use of the Kirkpatrick's triangle of evaluation strategies from level 1, reaction of learners, to level 2, self-efficacy of learning and skill uptake via standardized patient assessments, to level 3, transfer of skills into the clinic, and finally at level 4, patient outcome in response to the consultation for 896 patients assessed. We hypothesize that dose of training will directly impact skill uptake, will explore the proportion of variance in skill uptake attributable to facilitator competence and assess the change pre to post training in patient's perception of the quality of the clinician's communication. PUBLIC HEALTH RELEVANCE: This specialized R25 cancer education program for oncologists will develop and trial a comprehensive communication skills training curriculum aimed at improving the ability of medical, surgical and radiation oncology faculty and fellows to communicate with patients and families effectively about complex oncological issues.

描述（由申请人提供）：医患之间的有效沟通是优质医疗的基础。在肿瘤学领域，医患沟通尤为重要，因为肿瘤科医生与患者讨论棘手的问题。这些对话通常包括讨论预后、确保患者和家人了解治疗的显着风险和副作用、评估和应对心理困扰、管理护理从治疗目标到姑息目标的转变，以及努力接受死亡过程。研究表明，肿瘤科医生，特别是新培训的肿瘤科医生，很少接受过如何有效沟通此类问题的培训。因此，患者的信息和情感需求未得到满足，他们在整个护理过程中的适应受到与临床医生的互动和支持的影响。在过去的十年中，提高沟通技巧和功效的干预措施已经在随机对照试验中得到开发和测试，并已被证明在改变医生沟通方面有效。在综合癌症中心建立高级沟通技能培训项目是全国肿瘤学的关键培训需求。该应用程序通过仔细检查纪念斯隆-凯特琳癌症中心试点的教育计划来满足这一需求。 该提案的总体目标是制定肿瘤学沟通技能教育计划。该计划将通过三个核心予以支持：教育核心、教师发展和培训核心以及评估核心。该提案的具体目标是： 目标 1：通过教育核心实施综合癌症中心的沟通培训课程，以提高内科、外科和儿科研究员以及初级教员与患者和家属就复杂的肿瘤学问题进行有效沟通的能力问题;目标 2：通过教师发展和培训核心支持这一沟通培训课程。该培训核心将为主治医师维持一个教师发展计划，并将为协调员提供持续的培训和反馈，以更好地教授沟通技巧；目标 3：通过评估核心，通过多个级别的考试来评估这些项目对研究员和初级教师的结果，包括：自我评估、标准化患者评估的表现、临床遭遇的表现以及患者报告的结果。 在本提案中，我们将向 264 名参与者展示 7 个模块的教育计划的有效性，并通过使用柯克帕特里克三角评估策略来评估其有效性，从第 1 级（学习者的反应）到第 2 级（学习的自我效能）通过标准化患者评估进行技能吸收，达到第 3 级，将技能转移到诊所，最后达到第 4 级，根据对 896 名患者的咨询进行评估的患者结果。我们假设培训剂量将直接影响技能的吸收，将探讨由于辅导员能力而导致的技能吸收差异的比例，并评估培训前后患者对临床医生沟通质量的看法的变化。 公共健康相关性：这项专门针对肿瘤学家的 R25 癌症教育计划将开发和试验全面的沟通技巧培训课程，旨在提高内科、外科和放射肿瘤学教职员工和研究员与患者和家属就复杂肿瘤问题进行有效沟通的能力。