A new interactive training tool designed to help oncologists better address patient fears has been developed by a Duke University researcher. The program includes feedback on the doctors’ audio-recorded visits with patients and offers an alternative to higher-priced courses. The study appears in the Annals of Internal Medicine.
The research team found that the curriculum resulted in more empathic responses from oncologists. Furthermore, patients reported greater trust in their doctors, an important factor of care that enhances quality of life.
“Earlier studies have shown that oncologists respond to patient distress with empathy only about a quarter of the time,” said James A. Tulsky, MD, director of the Duke Center for Palliative Care and lead author of the study.
“Oncologists are among the most devoted physicians – passionately committed to their patients. Unfortunately, their patients don’t always know this unless the doctors articulate their empathy explicitly,” Tulsky said. “It’s a skill set. It’s not that the doctors are uncaring, it’s just that communication needs to be taught and learned.”
Tulsky’s team developed a computer program that models what happens in other multiday courses, which can cost upward of $3000 per physician. During the tutorial, the doctors receive feedback on prerecorded patient visits, and they are able to complete the program in their offices or homes in just over an hour. The cost for the tutorial is approximately $100.
To test the computer-based program’s effectiveness, Tulsky and his team enrolled 48 doctors at Duke, the Veterans Affairs Medical Center in Durham, NC, and the University of Pittsburgh Medical Center.
After the team audio-recorded 4 to 8 visits between the doctors and their patients with advanced cancer, all the doctors then attended a 60-minute lecture on communication skills. Subsequently, half of the doctors were randomly chosen to receive a CD-ROM tutorial, while the other half received no other training.
Lastly, all the doctors were recorded during patient visits again, and the meetings were critiqued by both patients and trained listeners. The conversations were evaluated based on how well the doctors responded to empathic statements.
When faced with patient concerns or fears, oncologists who did not receive the CD course made no improvement in the way they responded to patients. However, doctors in the CD-trained group responded empathically twice as often compared to those who received no training. Also, the trained doctors used tactics to promote conversations and, therefore, were better at acquiring patient concerns.
“Patient trust in physicians increased significantly,” Tulsky said, adding that patients report feeling better when they believe their doctors are on their side. “This is exciting, because it’s an easy, relatively inexpensive way to train physicians to respond to patients’ most basic needs.”
Source: Duke University.