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How to Optimize Physicians’ Communication Skills in Cancer Care: Results of a Randomized Study Assessing the Usefulness of Posttraining Consolidation Workshops

Darius Razavi, Isabelle Merckaert, Serge Marchal, Yves Libert, Sandrine Conradt, Jacques Boniver, Anne-Marie Etienne, Ovide Fontaine, Pascal Janne, Jean Klastersky, Christine Reynaert, Pierre Scalliet, Jean-Louis Slachmuylder, Nicole Delvaux

From the Université Libre de Bruxelles, Faculté des Sciences Psychologiques et de l’Éducation and Institut Jules Bordet; C.A.M. (Training and Research Group); Université Catholique de Louvain, Faculté de Médecine, Brussels; Hôpital Universitaire Erasme, Service de Psychologie, Brussels; Université Catholique de Louvain, Faculté de Psychologie et des Sciences de l’Éducation, Louvain-la-Neuve; Université de Liège, Faculté de Psychologie and Faculté de Médecine, Liège, Belgium.

Address reprint requests to Darius Razavi, MD, PhD, Université Libre de Bruxelles, Av F Roosevelt, 50-CP 191, B-1050 Bruxelles, Belgium; email: drazavi{at}ulb.ac.be.

Purpose: Although there is wide recognition of the usefulness of improving physicians’ communication skills, no studies have yet assessed the efficacy of post-training consolidation workshops. This study aims to assess the efficacy of six 3-hour consolidation workshops conducted after a 2.5-day basic training program.

Methods: Physicians, after attending the basic training program, were randomly assigned to consolidation workshops or to a waiting list. Training efficacy was assessed through simulated and actual patient interviews that were audiotaped at baseline and after consolidation workshops for the consolidation-workshop group, and approximately 5 months after the end of basic training for the waiting-list group. Communication skills were assessed according to the Cancer Research Campaign Workshop Evaluation Manual. Patients’ perceptions of communication skills improvement were assessed using a 14-item questionnaire.

Results: Sixty-three physicians completed the training program. Communication skills improved significantly more in the consolidation-workshop group compared with the waiting-list group. In simulated interviews, group-by-time repeated measures analysis of variance showed a significant increase in open and open directive questions (P = .014) and utterances alerting patients to reality (P = .049), as well as a significant decrease in premature reassurance (P = .042). In actual patient interviews, results revealed a significant increase in acknowledgments (P = .022) and empathic statements (P = .009), in educated guesses (P = .041), and in negotiations (P = .008). Patients interacting with physicians who benefited from consolidation workshops reported higher scores concerning their physicians’ understanding of their disease (P = .004).

Conclusion: Consolidation workshops further improve a communication skills training program’s efficacy and facilitate the transfer of acquired skills to clinical practice.

Supported by the Fonds National de la Recherche Scientifique-Section Télévie of Belgium and by the C.A.M., Training and Research Group, Brussels, Belgium.

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