Professional Abstract

Objective

To compare the effectiveness of an online, interactive communication training program for oncologists, versus standard communication training, in increasing patient satisfaction with oncologist communication

Study Design

Design Element	Description
Design	Randomized controlled trial
Population	148 ABIM-certified oncologists
Interventions/ Comparators	SCOPE: an online, interactive communication training program ABIM communication skills practice improvement module
Outcomes	Primary: patient satisfaction with oncologist communication  Secondary: oncologist responses to opportunities to show empathy
Timeframe	1-month follow-up for primary outcome

In this randomized controlled trial, the research team evaluated the effectiveness of the Studying Communication in Oncologist-Patient Encounters (SCOPE) program in increasing patient satisfaction with oncologist communication and the frequency of oncologist responses to opportunities to show empathy.

The research team randomly assigned oncologists to SCOPE or a standard communication improvement program. Before beginning their programs, all oncologists collected satisfaction surveys from five patients and audio-recorded clinic visits with four different patients.

Oncologists assigned to SCOPE received results from their patients’ satisfaction surveys and tailored feedback on their visit recordings. They then completed the five SCOPE modules: Principles of Effective Communication, Recognizing Empathetic Opportunities, Responding to Empathetic Opportunities, Conveying Prognosis, and Answering Difficult Questions. Each SCOPE module taught communication skills using video demonstrations. The modules also played audio clips from each oncologist’s clinic visits to show when they used the skills and to offer advice on alternate approaches when doctors used negative behaviors or missed opportunities to show empathy. Patient advocates from the study’s advisory board also provided feedback on the recordings. After completing the video lessons, oncologists recorded two more clinic visits and received another round of tailored feedback.

Oncologists in the control arm received satisfaction survey results and completed the American Board of Internal Medicine (ABIM) communication skills practice improvement module. This program did not provide feedback. Next, the oncologists identified areas for self-improvement and created an action plan for achieving their goals in those areas.

One month after completing their programs, all oncologists recorded four clinic visits and collected satisfaction surveys from a new sample of five patients. The oncologists submitted a total of 455 satisfaction surveys and 254 clinic visit recordings.

The study initially included 148 ABIM-certified oncologists, but only 27 completed the study. Of these, 63% were white, 22% were Asian, and 15% were other races. The average age was 53, and 85% were male.

A patient advisory council provided input throughout the study.

Results

Patient satisfaction with oncologist communication did not differ between the SCOPE and control groups. After one month, oncologists in SCOPE responded to a higher proportion of opportunities to show empathy than those in the control group at baseline (odds ratio=2.75; 95% confidence interval [CI]: 1.10, 7.01).

Limitations

The study did not reach its sample target of 100 oncologists completing the study, which limited the research team’s ability to detect differences between the SCOPE and control groups. Before the study, practice improvement modules were a required part of oncologists’ recertification process. During the study, such training became voluntary, which may have reduced study participation.

Conclusions and Relevance

The study did not find evidence that SCOPE increased patient satisfaction with oncologist communication. However, among those who completed the program, SCOPE improved oncologists’ reactions to opportunities to show empathy.

Future Research Needs

Future research could explore ways to integrate communication training into existing oncology quality improvement programs.