Improving Communication Between Cancer Patients & Oncologists

NCT ID: NCT02969031

Last Updated: 2020-01-03

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

148 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-02-14

Study Completion Date

2018-08-31

Brief Summary

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The overarching goal of this project is to improve communication between oncologists and their patients by ensuring that the patient's voice is heard in the medical encounter. Thus, the hope is to improve the experience for patients living with cancer. The investigators seek to accomplish this goal by providing oncologists communication skills training that includes feedback on their own audio-recorded conversations. The feedback will come from two sources: 1) Professional research assistant coders who will identify objective learning opportunities based on specific coding criteria and 2) Trained patient reviewers who will listen to the recordings and offer their own, subjective feedback at key moments in the encounters.

Detailed Description

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The primary objective of the Enhanced SCOPE program is to teach oncologists to recognize the role of emotion in discussions with cancer patients, to increase their self-efficacy for addressing affective concerns, and to provide them with the skills for doing so. Oncologists are most likely to achieve competency in these areas when, in addition to didactic training, they can also observe their own conversation and receive feedback on their interactions. The Enhanced SCOPE program itself is an online web application that can be viewed from any computer with internet connectivity. The investigators will be conducting a randomized controlled trial to test the impact on patient satisfaction and medical visit quality of a communication skills teaching intervention for oncologists that is integrated into the American Board of Internal Medicine (ABIM) Maintenance Of Certification (MOC) process. Oncologists who choose to enroll in this pilot Practice Improvement Module (PIM) will complete a baseline questionnaire, send out satisfaction surveys to a sample of their patients, and then audio record (using a smartphone application) eight clinic visits with eight different patients. Oncologists who are assigned to the control arm will receive the results of the patient surveys and be asked to conduct a quality improvement activity that responds to the feedback (the current "standard" communication PIM). Oncologists assigned to the intervention arm will receive the survey feedback as well as the enhanced SCOPE program that provides feedback on their audio-recorded encounters via a web based interactive program. The feedback will come from two sources: 1) Professional research assistant coders who will identify objective learning opportunities based on specific coding criteria (e.g., empathic opportunities, use of open-ended questions) and 2) Trained patient reviewers who will listen to the recordings and offer their own, subjective feedback at key moments in the encounters. These patient reviewers will be drawn from our stakeholder partners and are active patient advocates. They will be treated as members of the research team, paid for the reviews, and are not patients of the study physicians. One month after reviewing their feedback, oncologists in both arms will audio record another eight encounters and send out satisfaction surveys to a new sample of patients.

Conditions

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Cancer

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

NONE

Study Groups

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Enhanced SCOPE training

Complete a baseline questionnaire, administer satisfaction surveys anonymously to a sample of their patients, audio record (using a smartphone application) eight clinic visits with eight different patients. Receive survey feedback as well as the enhanced SCOPE program that provides feedback on their audio-recorded encounters via a web-based interactive program.

Group Type EXPERIMENTAL

Enhanced SCOPE training

Intervention Type BEHAVIORAL

Intervention is integrated into the American Board of Internal Medicine (ABIM) Maintenance Of Certification (MOC) process.

Standard Communication training

Complete a baseline questionnaire, administer satisfaction surveys anonymously to a sample of their patients. Receive the results of the patient surveys and be asked to conduct a quality improvement activity of their own design that responds to the feedback (the current "standard" communication PIM).

Group Type ACTIVE_COMPARATOR

Standard Communication training

Intervention Type BEHAVIORAL

Standard Communication training

Interventions

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Enhanced SCOPE training

Intervention is integrated into the American Board of Internal Medicine (ABIM) Maintenance Of Certification (MOC) process.

Intervention Type BEHAVIORAL

Standard Communication training

Standard Communication training

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* All American Board of Internal Medicine (ABIM) Board certified oncologists practicing in the U. S. and enrolled in Maintenance of Certification.
* Have a study-compatible smart phone.
* Eligible patients will have metastatic cancer.
* At least 18 years of age.
* Speak and read English.
* Receive oncology care from an enrolled oncologist.

Exclusion Criteria

* Dana Farber Cancer Institute oncologists and oncologists who do not speak English to their patients.
* Patients who do not speak English.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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American Board of Internal Medicine

OTHER

Sponsor Role collaborator

Duke University

OTHER

Sponsor Role collaborator

Patient-Centered Outcomes Research Institute

OTHER

Sponsor Role collaborator

Dana-Farber Cancer Institute

OTHER

Sponsor Role lead

Responsible Party

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James A. Tulsky

Chair, Department of Psychosocial Oncology and Palliative Care

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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James A. Tulsky, MD

Role: PRINCIPAL_INVESTIGATOR

Dana-Farber Cancer Institute

Locations

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Dana Farber Cancer Institute

Boston, Massachusetts, United States

Site Status

Countries

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United States

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Related Links

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https://www.dana-farber.org/research/departments-centers-and-labs/departments-and-centers/department-of-psychosocial-oncology-and-palliative-care/research/

Dana Farber Cancer Institute (DFCI), Department of Psychosocial Oncology and Palliative Care (POPC) Listing of Current Research and PCORI Award

https://www.vitaltalk.org/

Vital Talk is a non-profit whose mission is to nurture healthier connections between patients and clinicians. We are using Vital Talk intellectual property (e.g., REMAP) for the intervention

Other Identifiers

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16-099

Identifier Type: -

Identifier Source: org_study_id

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