On-site Supportive Communication Training in Doctor-patient Communication

NCT ID: NCT05842083

Last Updated: 2024-06-26

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

89 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-05-01

Study Completion Date

2024-06-25

Brief Summary

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The goal of this randomized, controlled clinical trial is to test a new concept for communication skills training (on-site supportive communication training (on-site SCT) in cancer care. The study aims to determine the impact of on-site SCT on patients' rating of oncologists' communication abilities.

Oncologists participating in the study will be randomly allocated to the intervention or control group. In the intervention group each doctor will have a total of three intervention days at intervals of 3-4 weeks. On an intervention day, a psychologist will sit in and observe doctor-patient consultations. After the first consultations, 30 minutes are allocated for feedback to the doctor by the psychologist. After the last consultation of the day, 60 minutes are allocated for thorough feedback and establishment of learning goals to focus on until the next intervention day. Doctor's in the control group will conduct communication as usual.

Researchers will compare the control and intervention groups to see if patients' rating of doctors' interpersonal and communication skills increase when the doctors have participated in on-site SCT. The 15-item Communication Assessment Tool (CAT) will be used.

It will also be investigated whether on-site SCT increases the doctors' rating of themselves in relation to communication efficacy and job satisfaction and decrease their experience of burnout.

Detailed Description

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Oncologists carry a heavy responsibility when delivering information to cancer patients and helping them navigate through decisions about life-altering treatments, survivorship, and end-of-life care. Comprehensive person-centered psychosocial cancer care should be adapted to the individual patient, which is obviously a challenging task (Dilworth, et al. 2014). Individualized and empathic communication, on the other hand, is of substantial importance to patient satisfaction, adherence to treatment, empowerment, and the ability to navigate in the disease trajectory (Gattellari, et al. 2001; Stewart 1995; Vogel, et al. 2009).

The quality of the communication in medical care has been shown to influence health outcomes, as it increases the risk of unnecessary treatment and is linked to insufficient pain relief and higher anxiety levels (Thorne, et al. 2005). Therefore, considerable effort has been dedicated to interventions that may improve the communication skills of healthcare professionals involved in cancer care (Moore, et al. 2018). The primary purpose has been to improve the quality of the doctor-patient-communication including the doctors' interpersonal skills.

Previous papers have suggested direct feedback on observed situations as an ideal method for improving communication skills (Anderson 2012; Burgess, et al. 2020), but to the best of our knowledge, no randomized clinical trials have used patient feedback during on-site training. Studies on communication skills training courses with recorded consultations/role-play have shown significant effect on key communication skills (Fallowfield, et al. 2002) and increased self-efficacy (Ammentorp, et al. 2007). Two studies have demonstrated long-term maintenance of acquired skills (Finset, et al. 2003; Gulbrandsen, et al. 2013). Until now, no effect on burnout has been demonstrated (Bragard, et al. 2010a; Bragard, et al. 2010b).

Clinical supervision and training aims to develop clinical practice and provide a protected space to allow an educational and reflective process to occur. Although there is still no empirical definition of the term supervision (Milne 2007), in 2004 Bernard and Goodyear defined it as "an intervention provided by a more senior member of a profession to a more junior member or members of that same profession"(Bernard 2004). On this premise, psychologists cannot formally supervise doctors and other terms must be used. In this project we therefore use the term "on-site supportive communication training" (on-site SCT) when referring to the intervention given by the psychologists.

Psychologists have a long tradition of working with communication, creating a reflective learning space, making observations and providing feedback. It is therefore highly relevant to use dedicated psychologists to investigate the effect of on-site SCT on the doctors' communication and on their experienced level of self-efficacy, satisfaction and burn-out.

Conditions

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Communication Programs Communication, Manual Communication Research Oncology Doctor Patient Relation Job Stress Burnout Satisfaction, Patient Efficacy, Self

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Oncologists will be randomized between the intervention and usual practice.
Primary Study Purpose

OTHER

Blinding Strategy

NONE

Study Groups

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Intervention

Each oncologist will have a total of three intervention days with a psychologist sitting in and observing the doctor-patient consultations and subsequently providing feedback.

Group Type ACTIVE_COMPARATOR

On-site supportive communication training

Intervention Type BEHAVIORAL

On-site supportive communication training

Control

Oncologists in the control group will conduct consultations as usual.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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On-site supportive communication training

On-site supportive communication training

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Medical doctors
* Employed at the Department of Oncology, Vejle Hospital, University Hospital of Southern Denmark or Aalborg University Hospital, or Zealand University Hospital, Roskilde/Naestved.
* Work in the outpatient clinics at the participating departments

Exclusion Criteria

* Doctors whose employment contracts will expire during the study and who do not plan to continue working at the department.
* Doctors who are not willing to sign the informed consent form.
Minimum Eligible Age

18 Years

Maximum Eligible Age

100 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Zealand University Hospital

OTHER

Sponsor Role collaborator

Aalborg University Hospital

OTHER

Sponsor Role collaborator

Vejle Hospital

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Kerstin Kiis Antonsen, MD

Role: PRINCIPAL_INVESTIGATOR

University Hospital of Southern Denmark - Vejle Hospital

Locations

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Department of Oncology, University Hospital of Southern Denmark - Vejle Hospital

Vejle, , Denmark

Site Status

Countries

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Denmark

References

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Dilworth S, Higgins I, Parker V, Kelly B, Turner J. Patient and health professional's perceived barriers to the delivery of psychosocial care to adults with cancer: a systematic review. Psychooncology. 2014 Jun;23(6):601-12. doi: 10.1002/pon.3474. Epub 2014 Feb 11.

Reference Type BACKGROUND
PMID: 24519814 (View on PubMed)

Gattellari M, Butow PN, Tattersall MH. Sharing decisions in cancer care. Soc Sci Med. 2001 Jun;52(12):1865-78. doi: 10.1016/s0277-9536(00)00303-8.

Reference Type BACKGROUND
PMID: 11352412 (View on PubMed)

Stewart MA. Effective physician-patient communication and health outcomes: a review. CMAJ. 1995 May 1;152(9):1423-33.

Reference Type BACKGROUND
PMID: 7728691 (View on PubMed)

Vogel BA, Leonhart R, Helmes AW. Communication matters: the impact of communication and participation in decision making on breast cancer patients' depression and quality of life. Patient Educ Couns. 2009 Dec;77(3):391-7. doi: 10.1016/j.pec.2009.09.005. Epub 2009 Oct 1.

Reference Type BACKGROUND
PMID: 19796910 (View on PubMed)

Thorne SE, Bultz BD, Baile WF; SCRN Communication Team. Is there a cost to poor communication in cancer care?: a critical review of the literature. Psychooncology. 2005 Oct;14(10):875-84; discussion 885-6. doi: 10.1002/pon.947.

Reference Type BACKGROUND
PMID: 16200515 (View on PubMed)

Moore PM, Rivera S, Bravo-Soto GA, Olivares C, Lawrie TA. Communication skills training for healthcare professionals working with people who have cancer. Cochrane Database Syst Rev. 2018 Jul 24;7(7):CD003751. doi: 10.1002/14651858.CD003751.pub4.

Reference Type BACKGROUND
PMID: 30039853 (View on PubMed)

Anderson PA. Giving feedback on clinical skills: are we starving our young? J Grad Med Educ. 2012 Jun;4(2):154-8. doi: 10.4300/JGME-D-11-000295.1.

Reference Type BACKGROUND
PMID: 23730434 (View on PubMed)

Burgess A, van Diggele C, Roberts C, Mellis C. Feedback in the clinical setting. BMC Med Educ. 2020 Dec 3;20(Suppl 2):460. doi: 10.1186/s12909-020-02280-5.

Reference Type BACKGROUND
PMID: 33272265 (View on PubMed)

Fallowfield L, Jenkins V, Farewell V, Saul J, Duffy A, Eves R. Efficacy of a Cancer Research UK communication skills training model for oncologists: a randomised controlled trial. Lancet. 2002 Feb 23;359(9307):650-6. doi: 10.1016/S0140-6736(02)07810-8.

Reference Type BACKGROUND
PMID: 11879860 (View on PubMed)

Ammentorp J, Sabroe S, Kofoed PE, Mainz J. The effect of training in communication skills on medical doctors' and nurses' self-efficacy. A randomized controlled trial. Patient Educ Couns. 2007 Jun;66(3):270-7. doi: 10.1016/j.pec.2006.12.012. Epub 2007 Mar 2.

Reference Type BACKGROUND
PMID: 17337337 (View on PubMed)

Finset A, Ekeberg O, Eide H, Aspegren K. Long term benefits of communication skills training for cancer doctors. Psychooncology. 2003 Oct-Nov;12(7):686-93. doi: 10.1002/pon.691.

Reference Type BACKGROUND
PMID: 14502593 (View on PubMed)

Gulbrandsen P, Jensen BF, Finset A, Blanch-Hartigan D. Long-term effect of communication training on the relationship between physicians' self-efficacy and performance. Patient Educ Couns. 2013 May;91(2):180-5. doi: 10.1016/j.pec.2012.11.015. Epub 2013 Feb 12.

Reference Type BACKGROUND
PMID: 23414658 (View on PubMed)

Bragard I, Etienne AM, Merckaert I, Libert Y, Razavi D. Efficacy of a communication and stress management training on medical residents' self-efficacy, stress to communicate and burnout: a randomized controlled study. J Health Psychol. 2010 Oct;15(7):1075-81. doi: 10.1177/1359105310361992. Epub 2010 May 7.

Reference Type BACKGROUND
PMID: 20453053 (View on PubMed)

Bragard I, Libert Y, Etienne AM, Merckaert I, Delvaux N, Marchal S, Boniver J, Klastersky J, Reynaert C, Scalliet P, Slachmuylder JL, Razavi D. Insight on variables leading to burnout in cancer physicians. J Cancer Educ. 2010 Mar;25(1):109-15. doi: 10.1007/s13187-009-0026-9.

Reference Type BACKGROUND
PMID: 20082173 (View on PubMed)

Milne D. An empirical definition of clinical supervision. Br J Clin Psychol. 2007 Nov;46(Pt 4):437-47. doi: 10.1348/014466507X197415.

Reference Type BACKGROUND
PMID: 17535535 (View on PubMed)

Bernard JM, & Goodyear, R. K. Fundamentals of clinical supervision, 2004.

Reference Type BACKGROUND

Iversen ED, Steinsbekk A, Falbe Vind B, Bangsgaard A, Cold S, Ammentorp J. Translation and cultural adaptation of the Communication Assessment Tool (CAT), developing a Danish and Norwegian version. Int J Qual Health Care. 2019 Dec 31;31(10):748-751. doi: 10.1093/intqhc/mzz020.

Reference Type BACKGROUND
PMID: 31220279 (View on PubMed)

Kristensen TS, Borritz M, Villadsen E, Christensen KB. The Copenhagen Burnout Inventory: A new tool for the assessment of burnout. Work & Stress. 2005;19(3):192-207.

Reference Type BACKGROUND

Axboe MK, Christensen KS, Kofoed PE, Ammentorp J. Development and validation of a self-efficacy questionnaire (SE-12) measuring the clinical communication skills of health care professionals. BMC Med Educ. 2016 Oct 18;16(1):272. doi: 10.1186/s12909-016-0798-7.

Reference Type BACKGROUND
PMID: 27756291 (View on PubMed)

Antonsen KK, Lyhne JD, Johnsen AT, Esser-Naumann S, Poulsen LO, Lund L, Timm S, Jensen LH. Assessing the effect of On-site supportive communication training (On-site SCT) on doctor burnout: a randomized controlled trial. BMC Med Educ. 2025 Jan 23;25(1):112. doi: 10.1186/s12909-025-06710-0.

Reference Type DERIVED
PMID: 39849449 (View on PubMed)

Kk A, At J, Lo P, Jd L, L L, S EN, S T, Lh J. Effects of on-site Supportive Communication Training (On-site SCT) on doctor-patient communication in oncology: Study protocol of a randomized, controlled mixed-methods trial. BMC Med Educ. 2024 May 10;24(1):522. doi: 10.1186/s12909-024-05496-x.

Reference Type DERIVED
PMID: 38730382 (View on PubMed)

Other Identifiers

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On-site SCT

Identifier Type: -

Identifier Source: org_study_id

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