The state of the science for communication training in pediatric oncology: A systematic review

Kaye, Erica C.; Cannone, Daniel; Snaman, Jennifer M.; Baker, Justin N.

doi:10.1002/pbc.28607

Cited by 18 publications

(13 citation statements)

References 39 publications

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“…Kaye et al. identified six published interventions, all from the United States 44 . Interventions included didactic workshops, case‐based role play, and bereaved parent teachings.…”

Section: Discussionmentioning

confidence: 99%

“…Given the importance of communication with the child with advanced disease about disease, palliative care, and EOL, the persisting communication barriers, and the lack of training reported, evidence‐based effective interventions should be offered to pediatric oncology HCPs. These may be established on theory, pedagogy, 44 and inductively, utilizing the vast clinical experience of HCPs.…”

Section: Discussionmentioning

confidence: 99%

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“Some things are even worse than telling a child he is going to die”: Pediatric oncology healthcare professionals perspectives on communicating with children about cancer and end of life

Laronne

Granek

Wiener

et al. 2021

Pediatric Blood & Cancer

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Introduction This study explored pediatric oncology healthcare professionals’ (HCPs) perspectives on direct communication with children with advanced disease about their disease, palliative care, and end‐of‐life (EOL) communication. Methods Forty‐six pediatric oncologists, nurses, psychosocial team members, and other HCPs from six hospital centers in Israel participated in semi‐structured interviews. The Grounded Theory method was used. Data were analyzed line‐by‐line with codes and categories developed inductively from participants’ narratives. Results HCPs viewed communication about disease progression and EOL as vital because children were often aware of their prognosis, because lack of communication could lead to emotional distress, and because communication is a prerequisite for shared decision‐making. HCPs identified several barriers for communication including HCP barriers (such as emotional strains, lack of training), parental barriers, guardianship law, and language and culture. HCPs also described strategies to promote EOL communication. Direct strategies include tailoring communication, allowing for silence, echoing children's questions, giving information gradually, and answering direct questions honestly. Indirect strategies included encouraging parents to talk to their children and teamwork with colleagues. Conclusions Open communication with children who have cancer is essential. Nevertheless, multiple barriers persist. The rising accessibility of online information calls for urgent training of HCPs in communication so that children will not turn to unmediated and potentially misleading information online in the absence of HCP communication. Evidence‐based effective communication training modules and emotional support should be offered to HCPs. Knowledge about children's development, age‐appropriate communication, and cultural sensitivity should be included in this training.

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“…Kaye et al. identified six published interventions, all from the United States 44 . Interventions included didactic workshops, case‐based role play, and bereaved parent teachings.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“Some things are even worse than telling a child he is going to die”: Pediatric oncology healthcare professionals perspectives on communicating with children about cancer and end of life

Laronne

Granek

Wiener

et al. 2021

Pediatric Blood & Cancer

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“…However, few interventions have been studied in pediatric oncology. 25 Recent review articles identified only 6 communication interventions in pediatric oncology 25,26 but 88 interventions in adult oncology. 25 Furthermore, these pediatric interventions were communication skills workshops, which target primarily individual-level barriers.…”

Section: Discussionmentioning

confidence: 99%

Multilevel barriers to communication in pediatric oncology: Clinicians' perspectives

Sisk

Friedrich

Kaye

et al. 2021

Cancer

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BACKGROUND: Communication serves several functions in pediatric oncology, but communication deficiencies persist. Little is known about the broad spectrum of barriers contributing to these deficiencies. Identifying these barriers will support new strategies to improve communication. METHODS: The authors performed 10 focus groups on perceived communication barriers with nurses, nurse practitioners, physicians, and psychosocial professionals across 2 academic institutions. They analyzed transcripts by adapting a multilevel framework from organizational psychology. RESULTS: The authors identified 6 levels of barriers to communication from the clinicians' perspectives: individual, team, organization, collaborating hospital, community, and policy. Individual barriers were subdivided into clinician characteristics, family characteristics, or characteristics of the clinician-family interaction. Within each level and sublevel, several manifestations of barriers were identified. Some barriers, such as a lack of comfort with difficult topics (individual), cultural differences (individual), a lack of a shared team mental model (team), and time pressure (organization), manifested similarly across professions and institutions. Other barriers, such as a need for boundaries (individual), intimidation or embarrassment of family (individual), unclear roles and authority (team), and excessive logistical requirements (policy), manifested differently across professions. With the exception of collaborating hospitals, participants from all professions identified barriers from each level. Physicians did not discuss collaborating hospital barriers. CONCLUSIONS: Nurses, nurse practitioners, physicians, and psychosocial professionals experience communication barriers at multiple levels, which range from individual-to policy-level barriers. Yet their unique clinical roles and duties can lead to different manifestations of some barriers. This multilevel framework might help clinicians and researchers to identify targets for interventions to improve communication experiences for families in pediatric oncology.

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“…Although difficult conversations have not been formally defined as a "procedure" in medicine, the medical community, including the Accreditation Council of Graduate Medical Education and other medical subspecialty societies, recognizes communication training as a priority [ 7 , 8 ]. Several communication training methods have been studied in different clinician populations: simulation, role-play, the use of cognitive maps, checklists, as well as deliberate practice and feedback have all been shown to improve performance or self-efficacy in navigating difficult conversations [ 9 - 19 ]. Specifically, the VitalTalk [ 20 ] curriculum enhances communication skills while increasing the frequency of empathic behaviors [ 21 , 22 ].…”

Section: Introductionmentioning

confidence: 99%

Teaching Communication as a Procedure by Utilizing a Mixed-Methods Curriculum: A Pilot Study

Levy¹,

Diaz²,

Dickerman³

2022

Cureus

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Objective In this study, we aimed to develop and pilot a mixed-methods curriculum among pediatric subspecialty fellows that combined didactics, role-play, and bedside coaching with a procedure card. We hypothesized that this curriculum would improve fellows’ ability to navigate difficult conversations and would be feasible to implement across training programs. Methods This study was conducted from 2019 to 2020. Phase 1 focused on establishing baseline performance. Phase 2 involved the education of participants and faculty. During phase 3, participants communicated difficult news to patients and families using the procedure card as a prompt with the aid of faculty coaching. Six months later, participants' performance was re-evaluated and compared with baseline performance. Results A total of 10 out of 17 (60%) participants completed the pilot study. Likert self-efficacy results revealed an improvement in the skill of delivering difficult news (3.0 pre-intervention, 4.1 post-intervention, p=0.0001), conducting a family conference (2.5 pre-intervention, 3.6 post-intervention, p=0.0001), and responding to emotions (3.4 pre-intervention, 4.2 post-intervention, p=0.0003). Investigator assessments showed improvement in fellows’ ability to communicate information clearly (2.5 pre-intervention, 3.9 post-intervention, p=0.0001) and demonstrate empathy (2.7 pre-intervention, 3.3 post-intervention, p=0.005). Conclusions In this pilot study, coaching at the bedside with a procedure-card prompt was effective at improving specific self-perceived and observed communication skills. Future research is needed to evaluate modifications to this curriculum to enhance its feasibility.

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The state of the science for communication training in pediatric oncology: A systematic review

Cited by 18 publications

References 39 publications

“Some things are even worse than telling a child he is going to die”: Pediatric oncology healthcare professionals perspectives on communicating with children about cancer and end of life

“Some things are even worse than telling a child he is going to die”: Pediatric oncology healthcare professionals perspectives on communicating with children about cancer and end of life

Multilevel barriers to communication in pediatric oncology: Clinicians' perspectives

Teaching Communication as a Procedure by Utilizing a Mixed-Methods Curriculum: A Pilot Study

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