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Alves-Nogueira AC, Góis AC, Pereira M, Canavarro MC, Melo C, Carona C. The Associations Between Physician-Patient Communication and Adjustment Outcomes of Patients and Physicians: A Systematic Review and Meta-Analysis of Correlations. HEALTH COMMUNICATION 2024; 39:1781-1794. [PMID: 37528769 DOI: 10.1080/10410236.2023.2243043] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/03/2023]
Abstract
Physician-Patient communication (PPC) has been linked to patient adjustment outcomes. However, conflicting results have been reported and previous systematic reviews showed some methodological weaknesses. It has also been suggested that PPC is related to physicians' own adjustment outcomes. This systematic review aims to explore and synthesize the associations between PPC and both patient and physician adjustment outcomes. A systematic search was conducted primarily in five databases and 11.488 non-duplicated articles were identified. Forty-five studies met the eligibility criteria and data extraction was performed for sample characteristics, PPC measurement, adjustment outcomes under examination and main outcomes. The observed results showed that the majority of the included studies were cross-sectional, assessed PPC by proxy-report and reported an overall positive association with patients' adjustment outcomes. None of the studies examined the association between PPC and physicians' adjustment outcomes. Thirty-three studies were meta-analyzed and showed a positive and significant association between PPC and patients' adjustment outcomes (r = .16). Due to the small number of studies included in the meta-analysis, the heterogeneity was high. Subgroup analysis could not identify sources for heterogeneity. Research on the associations between PPC and physicians' own adjustment outcomes is warranted. Future studies should be rigorous in defining clear PPC definitions, directionality of communication processes, and study design.
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Affiliation(s)
- Ana C Alves-Nogueira
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra
| | - Ana Carolina Góis
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra
| | - Marco Pereira
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra
| | - Maria Cristina Canavarro
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra
| | - Cláudia Melo
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra
| | - Carlos Carona
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra
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Banerjee SC, Parker PA, Staley JM, Manna R, Mahoney C, Liberman L. Mentor communication skills training: development, feasibility, and preliminary efficacy. BMC MEDICAL EDUCATION 2024; 24:646. [PMID: 38858656 PMCID: PMC11165731 DOI: 10.1186/s12909-024-05616-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 05/29/2024] [Indexed: 06/12/2024]
Abstract
BACKGROUND Mentoring is vital to career development in academic medicine, and communication underlies all aspects of the mentoring relationship. Although training research mentors has been shown to be effective, few academic medicine faculties have received training in how to mentor. The investigators developed a novel intervention, the Mentor Communication Skills Training for Oncology Faculty ("Comskil Mentor Training") and examined feasibility and preliminary efficacy. METHODS The study was a single arm pre-post intervention design. The intervention (Comskil Mentor Training) was offered in one virtual 3-hour session and included a didactic lecture with exemplary skill demonstration videos, facilitator-led small group role plays with trained actors, and evaluation. 19 faculty members from 12 departments participated in the training. RESULTS All participants completed the training. Overall, the training was rated favorably, with more than 80% of participants indicating that they "agreed" or "strongly agreed" with training evaluation. From pre- to post-training, significant improvement was seen in participants' overall self-efficacy to communicate with mentees, as well as participants' overall use of communication skills and mentoring-specific language. CONCLUSIONS Our findings support the feasibility and preliminary efficacy of a virtually delivered experiential mentor communication skills training program for multidisciplinary clinical and research faculty in oncology.
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Affiliation(s)
- Smita C Banerjee
- Associate Attending Behavioral Scientist, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 633 3rd Avenue, 4th Floor, New York, 10017, USA.
| | - Patricia A Parker
- Associate Attending Behavioral Scientist, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 633 3rd Avenue, 4th Floor, New York, 10017, USA
| | - Jessica M Staley
- Associate Attending Behavioral Scientist, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 633 3rd Avenue, 4th Floor, New York, 10017, USA
| | - Ruth Manna
- Associate Attending Behavioral Scientist, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 633 3rd Avenue, 4th Floor, New York, 10017, USA
| | - Cassidy Mahoney
- Associate Attending Behavioral Scientist, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 633 3rd Avenue, 4th Floor, New York, 10017, USA
| | - Laura Liberman
- Associate Attending Behavioral Scientist, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 633 3rd Avenue, 4th Floor, New York, 10017, USA
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Parker PA, Alici Y, Nelson C, Banerjee SC, Coyle N, Roth AJ, Manna R, Alexander K, Gonzalez J, Ewert R, Schofield E, Li Y, Korc-Grodzicki B. Geriatric Oncology Cognition and Communication (Geri-Onc CC): An interactive training for healthcare professionals. J Geriatr Oncol 2023; 14:101484. [PMID: 36989939 PMCID: PMC10106423 DOI: 10.1016/j.jgo.2023.101484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 01/03/2023] [Accepted: 03/20/2023] [Indexed: 03/29/2023]
Abstract
INTRODUCTION The number of older adults with cancer continues to increase. Many national and international organizations have called for the development of training opportunities for healthcare professionals (HCPs) to meet the unique needs of older adults with cancer and their families. MATERIALS AND METHODS We developed and implemented the Geriatric Oncology Cognition and Communication (Geri-Onc CC) training program for HCPs of all disciplines. This program included a two-day, intensive didactic and experiential training followed by six bi-monthly booster videoconference calls. We describe the format and content of this training, the preliminary results of program evaluation, as well as changes in knowledge, self-efficacy, and attitudes toward older adults pre- to post-training. RESULTS We describe data from the first six cohorts of HCPs who attended the training (n = 113). Participants rated the training highly favorably and reported that it met their training goals Mean = 4.8 (1-5 Scale). They also demonstrated a significant increase in their knowledge about geriatric oncology [(Pre-Mean = 6.2, standard deviation [SD] = 1.7; Post-Mean 6.8, SD = 1.6), p = 0.03] and self-efficacy in their ability to utilize the knowledge and skills they learned in the course [(Pre-Mean = 3.3, SD = 0.7; Post-Mean 4.5, SD = 0.4), p < 0.001]. There were no significant changes in attitudes toward older adults (p > 0.05), which were already very positive before the training. DISCUSSION There is a strong need for training in geriatric oncology. We have demonstrated that implementing this training was feasible, highly regarded, and positively impacted knowledge and self-efficacy regarding utilization of the knowledge and skills learned in the training.
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Affiliation(s)
- Patricia A Parker
- Memorial Sloan Kettering Cancer Center, New York, NY, USA; Weill Cornell Medical College, New York, NY, USA.
| | - Yesne Alici
- Memorial Sloan Kettering Cancer Center, New York, NY, USA; Weill Cornell Medical College, New York, NY, USA
| | - Christian Nelson
- Memorial Sloan Kettering Cancer Center, New York, NY, USA; Weill Cornell Medical College, New York, NY, USA
| | - Smita C Banerjee
- Memorial Sloan Kettering Cancer Center, New York, NY, USA; Weill Cornell Medical College, New York, NY, USA
| | - Nessa Coyle
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Andrew J Roth
- Memorial Sloan Kettering Cancer Center, New York, NY, USA; Weill Cornell Medical College, New York, NY, USA
| | - Ruth Manna
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Koshy Alexander
- Memorial Sloan Kettering Cancer Center, New York, NY, USA; Weill Cornell Medical College, New York, NY, USA
| | | | - Rebecca Ewert
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - Yuelin Li
- Memorial Sloan Kettering Cancer Center, New York, NY, USA; Weill Cornell Medical College, New York, NY, USA
| | - Beatriz Korc-Grodzicki
- Memorial Sloan Kettering Cancer Center, New York, NY, USA; Weill Cornell Medical College, New York, NY, USA
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A scoping review of ageism towards older adults in cancer care. J Geriatr Oncol 2023; 14:101385. [PMID: 36244925 DOI: 10.1016/j.jgo.2022.09.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 08/11/2022] [Accepted: 09/28/2022] [Indexed: 11/07/2022]
Abstract
INTRODUCTION Ageism towards older adults with cancer may impact treatment decisions, healthcare interactions, and shape health/psychosocial outcomes. The purpose of this review is twofold: (1) To synthesize the literature on ageism towards older adults with cancer in oncology and (2) To identify interventions that address ageism in the healthcare context applicable to oncology. MATERIALS AND METHODS We conducted a scoping review following Arksey and O'Malley and Levac methods and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We conducted an exhaustive multi-database search, screening 30,926 titles/abstracts. Following data abstraction, we conducted tabular, narrative, and textual synthesis. RESULTS We extracted data on 133 papers. Most (n = 44) were expert opinions, reviews, and letters to editors highlighting the negative impacts of ageism, expressing the need for approaches addressing heterogeneity of older adults, and calling for increased clinical trial inclusion for older adults. Qualitative studies (n = 3) described healthcare professionals' perceived influence of age on treatment recommendations, whereas quantitative studies (n = 32) were inconclusive as to whether age-related bias impacted treatment recommendations/outcomes or survival. Intervention studies (n = 54) targeted ageism in pre/post-licensure healthcare professionals and reported participants' improvement in knowledge and/or attitudes towards older adults. No interventions were found that had been implemented in oncology. DISCUSSION Concerns relating to ageism in cancer care are consistently described in the literature. Interventions exist to address ageism; however, none have been developed or tested in oncology settings. Addressing ageism in oncology will require integration of geriatric knowledge/interventions to address conscious and unconscious ageist attitudes impacting care and outcomes. Interventions hold promise if tailored for cancer care settings. 249/250.
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Rosa WE, Cannity K, Moreno A, Cardillo C, Schofield EA, Korc-Grodzicki B, Parker PA, Manna R, Alici Y, Nelson C, Alexander K, Banerjee SC. Geriatrics communication skills training program for oncology healthcare providers to improve the management of care for older adults with cancer. PEC INNOVATION 2022; 1:100066. [PMID: 36741338 PMCID: PMC9894477 DOI: 10.1016/j.pecinn.2022.100066] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Objective We evaluated the feasibility, acceptability, and preliminary efficacy of a novel intervention, the Geriatric Communication Skills Training Program (Geriatric Comskil Training) for multidisciplinary healthcare providers (HCPs). Methods Three 2-h modules comprised the training: Geriatrics 101, Cognitive Syndromes, and Shared Decision-Making. Modules consisted of didactic knowledge, exemplary videos, and experiential learning role plays with standardized patients. We collected pre- and post-training data from 11 HCPs (module evaluations, self-efficacy, communication skills uptake in interaction with standardized patients, perceived ageism) and 44 patients (perceived HCP empathy, satisfaction with HCP communication). Results HCPs rated all modules high, with over 90% agreement on all course evaluation items assessing involvement, critical thinking, and reflectiveness, and significant improvements in self-efficacy. HCPs demonstrated an uptake in communication skills from pre- to post-training in agenda setting and overall skill use and reported promising trends towards lower ageism scores (d = 0.58). Promising trends in patient-reported HCP empathy (d = 0.39) and satisfaction with communication (d = 0.29) emerged from pre- to post-training. Conclusion Continued efforts are needed to strengthen HCP education related to geriatric communication across the cancer continuum. Innovation The Geriatric Comskil Training demonstrated feasibility, acceptability, and increases in self-efficacy and communication skills uptake for HCPs.
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Affiliation(s)
| | | | - Aimee Moreno
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Cara Cardillo
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | | | | | - Ruth Manna
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Yesne Alici
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | | | - Smita C. Banerjee
- Memorial Sloan Kettering Cancer Center, New York, NY, USA,Corresponding author at: Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 641 Lexington Ave., 7th Floor, New York, NY 10022, USA., (S.C. Banerjee)
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Banerjee SC, Staley JM, Alexander K, Parker PA, Haviland KS, Moreno A, Walters CB. Sexual and Gender Minority Communication Skills (SGM Comskil) Training for Oncology Clinicians: Development, Implementation, and Preliminary Efficacy. ANNALS OF LGBTQ PUBLIC AND POPULATION HEALTH 2021; 2:35-52. [PMID: 37475763 PMCID: PMC10358276 DOI: 10.1891/lgbtq-2020-0016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/22/2023]
Abstract
Enhancing communicative competence of healthcare providers (HCPs) is a critical initiative for improving the healthcare experience of sexual and gender minority (SGM) cancer patients. This study presents the development, implementation, and preliminary efficacy of a new training curriculum for improving oncology HCPs' skills in providing a safe and welcoming environment for SGM cancer patients (SGM Comskil training). Thirty-three (N = 33) oncology HCPs including nurses, nurse leaders, and nurse practitioners participated in a 4.25-hour SGM Comskil Training between July and August 2019. Overall, participants reported highly favorable evaluations of the training, with more than 80% of the participants reacting positively to 12 of the 15 evaluation items assessing engagement and reflectiveness for experiential role-plays with lesbian, gay, bisexual (LGB) and transgender standardized patients (SPs), respectively. Participants also demonstrated significant improvements in SGM healthcare knowledge, self-efficacy, beliefs toward LGB and transgender persons, and SGM-sensitive language use skills following the training. Encouraged by the feasibility of conducting this experiential training with busy cancer care HCPs and the initial favorable participant evaluation of the SGM Comskil training, results clearly indicate that this training can be rolled out into clinical settings to ensure its translational potential. The next steps should assess observable changes in communication skills and SGM-sensitive language skills with SGM patients and improvements in SGM patients' healthcare experience.
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Affiliation(s)
| | | | | | | | | | - Aimee Moreno
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
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Fitch MI, Nicoll I, Lockwood G, Newton L, Strohschein FJ. Improving survivorship care: Perspectives of cancer survivors 75 years and older. J Geriatr Oncol 2020; 12:453-460. [PMID: 32962951 DOI: 10.1016/j.jgo.2020.09.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 09/08/2020] [Accepted: 09/10/2020] [Indexed: 12/15/2022]
Abstract
PURPOSE This work describes perspectives of older adult cancer survivors about improvements that should be considered during the early period of survivorship. Findings will be useful in program development of age-appropriate services following completion of cancer treatment for older adults. METHODS A national survey was conducted across ten Canadian provinces to understand follow-up experiences of cancer survivors one to three years post-treatment. The survey included open-ended questions enabling respondents to offer insight into their experiences. This publication presents analysis of responses from older adults (75+ years) about suggestions for improving survivorship care. RESULTS In total, 3274 older adults (75+ years) responded to the survey and 1424 responded to the question about improvements. Fifty-five percent of the older adults were male, 28% had experienced metastatic disease and 75% reported comorbid conditions. A total of 640 respondents offered 932 suggestions in the areas of service delivery (n = 763, 81.9%), support (n = 108, 11.6%), and practical assistance (n = 61, 6.5%). Improvements in information/communication (n = 291) and follow-up care (n = 180) accounted for the highest number of suggestions regarding service delivery. Thematic analysis revealed three key messages about improvement: 'offer me needed support', 'make access easy for me', and 'show me you care'. CONCLUSION Suggestions for improvement in survivorship care by older adults treated for cancer emphasize need for changes in the approaches taken by health care providers in interactions and organization of care delivery. Proactive provision of information, detailed schedules for follow-up care, and ease of access to post-treatment care are needed.
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Affiliation(s)
- Margaret I Fitch
- Bloomberg Faculty of Nursing, University of Toronto, 207 Chisholm Ave, Toronto, Ontario M4C 4V9, Canada.
| | | | | | - Lorelei Newton
- School of Nursing, University of Victoria, PO Box 1700 STN CSC, Victoria, BC V8W 2Y2, Canada.
| | - Fay J Strohschein
- Oncology and Aging Program, Jewish General Hospital, Wainwright, Montreal, Alberta, Canada.
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