A rigorous evaluation of an institutionally-based communication skills program for post-graduate oncology trainees

Bylund, Carma L.; Banerjee, Smita C.; Bialer, Philip A.; Manna, Ruth; Levin, Tomer T.; Parker, Patricia A.; Schofield, Elizabeth; Li, Yuelin; Bartell, Abraham; Chou, Alexander J.; Hichenberg, Shira; Dickler, Maura N.; Kissane, David W.

doi:10.1016/j.pec.2018.05.026

Cited by 46 publications

(50 citation statements)

References 30 publications

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“…In this study, significant SEGUE score increases were found both immediately after programme (OR = 7.017, p < 0.001) and 1 month after programme (OR = 11.716, p < 0.001) for trainees with lower baseline scores. This finding was in line with a previous study by Bylund et al [18]. They also found that participants with lower baseline scores had larger improvements with both standardized and real patients.…”

Section: Discussionsupporting

confidence: 93%

Effectiveness of a modified doctor–patient communication training Programme designed for surgical residents in China: a prospective, large-volume study at a single Centre

Bai

Yao

et al. 2019

BMC Med Educ

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Background Effective doctor-patient communication (DPC) is important to improve the quality of care and treatment outcomes. This study aimed to evaluate the effectiveness of a modified DPC training programme designed for surgical residents in China. Methods A total of 210 surgical residents from 7 specialties were recruited to participate in a communication skills training programme. The extended SEGUE scale was administered to supervisors, and a visual analogue scale (VAS) was administered to standardized patients (SPs) and trainees. Evaluations were conducted by comparing the pre-post scale scores (before, immediately after and 1 month after the programme). Training effects were assessed using the Friedman test and the intraclass correlation coefficient (ICC). Results Compared to the extended SEGUE scale total scores before the programme, the scores both immediately after and 1 month after the program increased significantly (15.88 ± 1.93 vs. 26.40 ± 1.47 and 26.15 ± 1.36, respectively, p < 0.001). The scores of five of the six dimensions in the extended SEGUE scale significantly increased (p < 0.001), except for the patient’s perspective dimension score, which had no change ( p = 0.162). With respect to this dimension, a subgroup analysis by gender indicated an increase among females ( p < 0.001) and a decrease among males (p < 0.001). The VAS scores, which were evaluated for the SPs and trainees, increased significantly compared to the scores before the program, both immediately after and 1 month after the programme (4.31 ± 1.35 vs. 7.36 ± 1.62 and 7.34 ± 1.24, p < 0.001; 7.31 ± 1.25 vs. 8.39 ± 1.32 and 8.30 ± 1.24, p < 0.001, respectively). The consistency of the VAS between the SPs and surgical residents was 0.26 ( p < 0.001), 0.70 (p < 0.001), and 0.70 (p < 0.001) before, immediately after and 1 month after the programme, respectively. Conclusion This training programme improved the DPC competency of surgical residents, effectively increased the levels of satisfaction of both SPs and surgical residents, and improved the consistency of evaluation between SPs and surgical residents during doctor-patient encounters. The registration UIN is ChiCTR1800019790 from November 28, 2018. Electronic supplementary material The online version of this article (10.1186/s12909-019-1776-7) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 93%

Effectiveness of a modified doctor–patient communication training Programme designed for surgical residents in China: a prospective, large-volume study at a single Centre

Bai

Yao

et al. 2019

BMC Med Educ

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“…Moreover, in the development process of the training concepts it should be taken into account, that different skills/domains may need different intensity of work to be changed, probably dependent on the prior knowledge/skills of the physician. A study by Bylund and colleagues [ 40 ] describes, for example, that although no transfer was observed in the trained physicians as a whole, the subgroup of the weaker physicians at baseline showed significant changes on their communicative behavior. Here also arises a further challenge for future research: only a better understanding of the learning processes [ 44 ] and the learning context [ 39 , 45 ] of the physicians will allow an enhancement of the training methods.…”

Section: Discussionmentioning

confidence: 99%

“…A crucial question remains how to transfer skills into clinical practice [ 39 ]. Studies have shown that the effects of the training are minor when assessed with real patients and do not last long, the effect disappearing after no later than one year [ 2 , 7 , 34 , 40 ]. This problem of low transfer despite intensive work is known from Organization Psychology [ 41 ] and has triggered significant research, the aim of which is to better understand how transfer works and identify which factors support or disturb this process [ 25 , 42 – 44 ].…”

Section: Introductionmentioning

confidence: 99%

ComOn-Coaching: The effect of a varied number of coaching sessions on transfer into clinical practice following communication skills training in oncology: Results of a randomized controlled trial

et al. 2018

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ObjectiveTo investigate the effect of the number of coaching sessions after communication skills training on the medical communicative performance of oncologists in clinical practice.Methods/DesignThe training, consisting of a workshop and one (control group) vs. four (intervention group) sessions of individual coaching, was evaluated in a randomized controlled trial. Eligible participants included physicians working in any setting where patients with oncological diseases were treated. Real medical consultations were video recorded at three time points: before the workshop (t0), after the workshop (t1) and after completion of coaching (t2). The 1.5-day workshop was based on role-playing in small groups; in the coaching sessions, the videos recorded at t1 were analyzed in detail by both the trainer and the physician. The coaching sessions were manualized and based on the physician’s learning goals. The primary hypothesis was that the intervention group would improve to a higher extent than the control group, as assessed by external raters using rating scales specially developed for this project. Physicians were stratified for sex and setting and randomized by an independent statistician. The group assignment was revealed for physicians and trainers at the end of the workshop, while the raters were blinded to group assignments and assessment points.ResultsA total of 72 physicians participated in one of 8 workshops and could be allocated to either the control or intervention group. The intervention group showed a statistically significant improvement (ES d = 0.41, p<.01) in the All items domain of the rating scales between t1 and t2 and showed a significant advantage compared with the CG (ES = .41, p = .04). The impact on diverse specified skills was heterogeneous; a larger sample is necessary for more detailed analysis.ConclusionsThe training achieved some observable and significant changes in the communicative behavior of oncologists in clinical practice. The four coaching sessions showed some significant advantages compared to the single coaching session. Considerable effort is necessary to achieve sustained changes in communication in clinical every-day practice. Thus, our coaching concept is a promising method for this purpose.

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“…The Kirkpatrick Assessment Model's application to communication skills education programs has been found to be a good fit. 17 The model does not explicitly consider the length of time that has passed in its evaluation levels, although it is somewhat implicit, particularly at the highest level. In other words, the highest level of "result" may take some time to become apparent.…”

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confidence: 99%

“…Conventional wisdom among healthcare communication educators is that learned skills drop off over time, but there are few data to support this, with only a few studies that show mixed results. 17,[19][20][21] We considered whether an innovative and feasible approach to gaining some insight into the long-term effect of the course would be to conduct a cross-sectional study of participants who had completed a communication skills course at varying times (6-36 months ago) to assess the long-term effect at the third level of the Kirkpatrick modelbehavior. Specifically, we wanted to examine whether time since course completion was related to reported use of communication skills learned in the course, allowing for a snapshot of the effect of communication skills education on doctors' behavior over time.…”

mentioning

confidence: 99%

<p>The Impact of a Communication Skills Workshop on Doctors’ Behavior Over Time</p>

Bylund¹,

Adams²,

Sinha³

et al. 2020

AMEP

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Purpose: Communication skills education is still relatively new in some non-Western countries. Further, most evaluation research on communication skills education examines only short-term results. In our communication skills program in Qatar, we aimed to: 1) assess the impact of the communication skills course on participant skills application; 2) assess the length of time since course completion associated with participant skills application; and 3) assess participant gender or clinical position associated with participant skills application. Methods: Seven hundred and thirty-eight physicians completed a seven-module communication skills course. Participants reflected on what they learned in the course and how the course had impacted their behavior through a nine-item online survey that included a fouritem Communication Workshop Impact Scale (CWIS), three open questions, and two demographic questions. To assess the effect of time since workshop on outcomes, we stratified the respondents into five groups based on how long ago they had completed the course. Results: Three hundred and thirty-two physicians completed the survey. Participants reported agreement with the items on the CWIS: X=4.45 (range 1-5; SD=0.70). When asked which skill(s) they had been able to implement in their clinical practice, 235 gave a specific response, either a specific communication skill (eg, ask open questions), a higherorder category of skills (eg, questioning skills), or the name of one of the seven modules of the course. Only 28 participants listed the name of a skill or module name that they had not been able to implement. There was no evidence of difference in CWIS score based on time since course completion. There was no gender difference; however, residents had significantly lower CWIS scores than fellows (4.70 vs. 4.29, p<0.05). Conclusion: Participants reported agreement with response items about the impact of the course on their skills application. Participant gender did not play a significant role, but residents had lower scores than did fellows. Furthermore, most physicians (92%) were able to name something specific that they had learned from the course and were currently implementing in their practice. Positive outcomes of the course did not seem to diminish over time. Future research should identify whether observable communication behavior matches the self-reported behavior.

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A rigorous evaluation of an institutionally-based communication skills program for post-graduate oncology trainees

Cited by 46 publications

References 30 publications

Effectiveness of a modified doctor–patient communication training Programme designed for surgical residents in China: a prospective, large-volume study at a single Centre

Effectiveness of a modified doctor–patient communication training Programme designed for surgical residents in China: a prospective, large-volume study at a single Centre

ComOn-Coaching: The effect of a varied number of coaching sessions on transfer into clinical practice following communication skills training in oncology: Results of a randomized controlled trial

<p>The Impact of a Communication Skills Workshop on Doctors’ Behavior Over Time</p>

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