Computer-Based Learning Program Improves Communications Between Oncologists and Patients

Computer-Based Learning Program Improves Communications

Between Oncologists and Patients

WASHINGTON – Showing doctors recordings of their interactions with patients may boost their ability to show empathy and communicate effectively, according to a study by researchers with the Department of Veterans Affairs (VA) and university partners. The findings appear in the Nov. 1 Annals of Internal Medicine. 

“VA’s advancements in medical research lead to better care for Veterans,” said Secretary of Veterans Affairs Eric K. Shinseki. “VA is always striving to improve the care we provide Veterans.”

The research team audio-recorded four to eight visits between the doctors and their patients with advanced cancer. All the doctors then attended an hour-long lecture and discussion on effective communications skills. Afterwards, half were randomly assigned to receive a CD-ROM communications skills tutorial, along with personalized feedback and video clips to watch; the other half received no additional information. The CD taught the doctors how to recognize and respond to opportunities in conversations when patients share negative emotions, and how to empathetically discuss their prognosis. 

Subsequently, all oncologists were again recorded during patient visits, and the recordings were assessed by both patients and trained listeners. Oncologists who did not take the CD course made no improvement in the way they responded. Doctors in the CD-trained group responded empathically to patients’ concerns or fears twice as often as those who received no training. Also, patients of the intervention group reported greater trust in their doctors – a key component of care that enhances quality of life.

According to lead author Dr. James A. Tulsky, resident at the Durham VA Medical Center, and his colleagues, the intervention likely worked for three reasons.

“First, it was grounded in a strong theoretical foundation and incorporated principles of adult learning,” they wrote. “Second, it used structured feedback based on the physicians’ own audio-recorded conversations, which allowed physicians to hear their own shortcomings and successes. Finally, the intervention supplied oncologists with a handful of tools they could remember and apply in patient encounters.”  

The 48 VA and non-VA doctors who took part in the study also received individualized feedback and watched video clips that modeled communications skills. The intervention was evaluated by a team with the Durham and Pittsburgh VA Medical Centers and Duke University, University of Texas, and University of Pittsburgh. The work was funded by the National Cancer Institute.

“This simple technology can improve oncologists’ empathic behavior and, consequently, patient trust, leading to improved adherence to therapy,” the researchers wrote. “Future research should evaluate the effect of such an approach on both oncologists and patients over time.”  

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