Sexual and Gender Minority Communication Skills (SGM Comskil) Training for Oncology Clinicians: Development, Implementation, and Preliminary Efficacy

Abstract

Enhancing communicative competence of healthcare providers (HCPs) is a critical initiative for improving the healthcare experience of sexual and gender minority (SGM) cancer patients. This study presents the development, implementation, and preliminary efficacy of a new training curriculum for improving oncology HCPs’ skills in providing a safe and welcoming environment for SGM cancer patients (SGM Comskil training). Thirty-three (N = 33) oncology HCPs including nurses, nurse leaders, and nurse practitioners participated in a 4.25-hour SGM Comskil Training between July and August 2019. Overall, participants reported highly favorable evaluations of the training, with more than 80% of the participants reacting positively to 12 of the 15 evaluation items assessing engagement and reflectiveness for experiential role-plays with lesbian, gay, bisexual (LGB) and transgender standardized patients (SPs), respectively. Participants also demonstrated significant improvements in SGM healthcare knowledge, self-efficacy, beliefs toward LGB and transgender persons, and SGM-sensitive language use skills following the training. Encouraged by the feasibility of conducting this experiential training with busy cancer care HCPs and the initial favorable participant evaluation of the SGM Comskil training, results clearly indicate that this training can be rolled out into clinical settings to ensure its translational potential. The next steps should assess observable changes in communication skills and SGM-sensitive language skills with SGM patients and improvements in SGM patients’ healthcare experience.

Family caregiver inclusion is not a level playing field: toward equity for the chosen families of sexual and gender minority patients

“…Communication trainings that involve experiential, role-play opportunities provide an evidence-based platform to increase communication skill uptake and self-efficacy while creating space to reflect on personal biases. 24 The facilitators, barriers, and considerations for the implementation of competency-based education to enhance person-centered chosen family caregiver support among SGM groups must be assessed within a given health and social care setting and adapted as needed. 25 Incorporating such trainings as foundational or mandatory where possible for health professionals and staff, as well as performing longitudinal assessment of health care provider sustainment of these communication competencies, are tangible steps toward equity.…”

“…Finally, health providers and systems must be able to respond to patient-family units using a relationship-based approach that is both effective and empathic. 24 In addition to systemic culture change and implicit bias education, there must also be mechanisms to track discriminatory behaviors, ensure nonretaliatory reporting of biased practices, and enforce non-negotiable consequences. If SGM patients are not returning to a given clinic or provider: pay attention, inquire about their experiences, and address issues at all relevant levels.In addition, part of being SGM friendly is having SGM staff and treating them well.…”

Communicating with LGBTQ+ persons at end of life: A case‐based analysis of interdisciplinary palliative clinician perspectives

“…Evidence‐based communication training may be a pathway to help translate knowledge to practice 36–38 . For example, previous research suggests that interdisciplinary clinicians who experienced a didactic and experiential communication skills training program focused on LGBTQ + sensitivity and safety demonstrated significant post‐training improvements in relevant healthcare knowledge, communication self‐efficacy, beliefs toward LGBTQ + persons, and sensitive language use skills 22 …”

Empathic communication: The premise of inclusive care for historically excluded populations

“…3 Furthermore, in a SGM sensitivity communication program for nursing professionals (n = 33), our team merged empathic communication skills education with evidence-based didactics in SGM health care knowledge and SGM-sensitive language. 4 Eighty percent of the participants responded positively to 12 of 15 evaluation items that assessed engagement and reflectiveness during experiential role-playing with SGM standardized patients, and the use of positive SGM-sensitive language improved significantly (P < .001) from before to after training.…”

“…For those experiencing lung cancer stigma, our sample of 30 interdisciplinary oncology health care clinicians demonstrated an overall increase in the use of empathic communication skills ( P < .05) and stigma‐mitigating skills ( P < .001) from before to after training 3 . Furthermore, in a SGM sensitivity communication program for nursing professionals (n = 33), our team merged empathic communication skills education with evidence‐based didactics in SGM health care knowledge and SGM‐sensitive language 4 . Eighty percent of the participants responded positively to 12 of 15 evaluation items that assessed engagement and reflectiveness during experiential role‐playing with SGM standardized patients, and the use of positive SGM‐sensitive language improved significantly ( P < .001) from before to after training.…”