Efficacy of communication skills training for giving bad news and discussing transitions to palliative care

Anthony L. Back, Robert M. Arnold, Walter F. Baile, Kelly A. Fryer-Edwards, Stewart C. Alexander, Gwyn E. Barley, Ted A. Gooley, James A. Tulsky

Research output: Contribution to journalArticle

441 Citations (Scopus)

Abstract

Background: Few studies have assessed the efficacy of communication skills training for postgraduate physician trainees at the level of behaviors. We designed a residential communication skills workshop (Oncotalk) for medical oncology fellows. The intervention design built on existing successful models by teaching specific communication tasks linked to the patient's trajectory of illness. This study evaluated the efficacy of Oncotalk in changing observable communication behaviors. Methods: Oncotalk was a 4-day residential workshop emphasizing skills practice in small groups. This preintervention and postintervention cohort study involved 115 medical oncology fellows from 62 different institutions during a 3-year study. The primary outcomes were observable participant communication skills measured during standardized patient encounters before and after the workshop in giving bad news and discussing transitions to palliative care. The standardized patient encounters were audiorecorded and assessed by blinded coders using a validated coding system. Before-after comparisons were made using each participant as his or her own control. Results: Compared with preworkshop standardized patient encounters, postworkshop encounters showed that participants acquired a mean of 5.4 bad news skills (P <. 001) and a mean of 4.4 transitions skills (P <. 001). Most changes in individual skills were substantial; for example, in the bad news encounter, 16% of participants used the word "cancer" when giving bad news before the workshop, and 54% used it after the workshop (P <. 001). Also in the bad news encounter, blinded coders were able to identify whether a standardized patient encounter occurred before or after the workshop in 91% of the audiorecordings. Conclusion: Oncotalk represents a successful teaching model for improving communication skills for postgraduate medical trainees.

Original languageEnglish (US)
Pages (from-to)453-460
Number of pages8
JournalArchives of internal medicine
Volume167
Issue number5
DOIs
StatePublished - Mar 12 2007

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Palliative Care
Communication
Education
Medical Oncology
Teaching
Cohort Studies
Physicians
Neoplasms

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Back, A. L., Arnold, R. M., Baile, W. F., Fryer-Edwards, K. A., Alexander, S. C., Barley, G. E., ... Tulsky, J. A. (2007). Efficacy of communication skills training for giving bad news and discussing transitions to palliative care. Archives of internal medicine, 167(5), 453-460. https://doi.org/10.1001/archinte.167.5.453

Efficacy of communication skills training for giving bad news and discussing transitions to palliative care. / Back, Anthony L.; Arnold, Robert M.; Baile, Walter F.; Fryer-Edwards, Kelly A.; Alexander, Stewart C.; Barley, Gwyn E.; Gooley, Ted A.; Tulsky, James A.

In: Archives of internal medicine, Vol. 167, No. 5, 12.03.2007, p. 453-460.

Research output: Contribution to journalArticle

Back, AL, Arnold, RM, Baile, WF, Fryer-Edwards, KA, Alexander, SC, Barley, GE, Gooley, TA & Tulsky, JA 2007, 'Efficacy of communication skills training for giving bad news and discussing transitions to palliative care', Archives of internal medicine, vol. 167, no. 5, pp. 453-460. https://doi.org/10.1001/archinte.167.5.453
Back, Anthony L. ; Arnold, Robert M. ; Baile, Walter F. ; Fryer-Edwards, Kelly A. ; Alexander, Stewart C. ; Barley, Gwyn E. ; Gooley, Ted A. ; Tulsky, James A. / Efficacy of communication skills training for giving bad news and discussing transitions to palliative care. In: Archives of internal medicine. 2007 ; Vol. 167, No. 5. pp. 453-460.
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