Prof Fallowfield, head of Cancer Research UK’s Psychosocial Oncology Group at the University of Sussex, designed a major randomised controlled trial to measure the effect of the training course on the psychosocial attitudes and beliefs of cancer doctors and on the way they communicated with patients after the course. Around 160 doctors and over 2,000 patients at 34 cancer centres throughout the UK took part in the study. One part of it involved 93 doctors who were randomised to attend a three-day residential course or to a control group that did not. Before and after attending the course they completed a questionnaire on their psychosocial beliefs. They were videoed carrying out patient consultations before and after the course, and they also completed a self-assessment questionnaire after the course, recording how they perceived their communication skills had changed.
Prof Fallowfield said: “We found that doctors who attended the course showed significantly more positive attitudes and beliefs towards psychosocial issues compared to those who were not on the course. This improvement was reflected in the analysis of the video-taped recordings of their communication behaviour with patients, which was significantly more patient-centred. The course group exhibited more empathy, used fewer leading questions, made more appropriate responses to patient cues and did more psychosocial probing than those who did not attend a course. These objective findings matched the doctors’ own subjective reports on how they perceived changes in their communication style with patients.
“These findings are important because there are many examples of positive benefits for patients when doctors adopt a patient-centred approach to treatment and care. Patients are more likely to comply with the treatment, there is better control of diabetes and hypertension, patients are more satisfied and both patient and doctor have a greater understanding of the symptoms and side-effects.”
Prof Fallowfield said that the results from this study proved that a carefully designed three-day course which contained training on behaviour, understanding, perception and emotion could not only make doctors adopt better communicating styles, but could also alter their attitudes and beliefs, thereby increasing the chances of them continuing to use their more patient-centred skills in the clinic.
She said: “Time and experience alone does not help cancer doctors to overcome the difficulties they have in communicating with patients, with patients’ relatives, and with professional colleagues. However a three-day training course produced significant subjective and objective changes in communication skills. We hope that our results can contribute to the many calls for improvements in this core clinical skill. A centrally-funded programme in communication skills needs to be established. To date we rely on the cancer charities supported by industry to fund this type of thing. It isn't good enough to wait for medical school training to filter through – senior doctors, who are the primary role models for juniors, need training.”
For further information, contact Emma Mason, Margaret Willson, or Maria Maneiro at the EBCC3 press office in Barcelona, tel: +34 93 364 4487, or Emma Mason's mobile +44 (0)7711 296 986, or Margaret Willson's mobile + 44 (0)7973 853 347.