Discussing randomised clinical trials of cancer therapy: evaluation of a Cancer Research UK training programme.
OBJECTIVE
To evaluate a training intervention aimed at improving healthcare professionals' communication with cancer patients about randomised clinical trials.


METHODS
Before and after evaluation of training programme.


METHODS
Members of the National Cancer Research Network, Scottish Trials Network, and the Welsh Cancer Trials Network.


METHODS
101 healthcare professionals (33 clinicians and 68 research nurses).


METHODS
Four modules delivered by a trained facilitator using videotapes and interactive exercises to cover general issues about discussing randomised clinical trials with patients, problems specific to adjuvant trials, trials with palliation as the goal, and trials where patients had a strong preference for one treatment arm.


METHODS
Before and after the intervention, participants were videotaped discussing a trial with an actor portraying a patient. These consultations were assessed for presence of information required by good clinical practice guidelines. The actor patients gave an assessment after each interview. Participants reported their self confidence about key aspects of trial discussion.


RESULTS
Analysis of the videotaped consultations showed that, after intervention, significantly more participants displayed key communication behaviours such as explaining randomisation (69 v 81, odds ratio 2.33, P = 0.033), checking patients' understanding (11 v 31, odds ratio 3.22, P = 0.002), and discussing standard treatment (73 v 88, odds ratio 4.75, P = 0.005) and side effects (69 v 85, odds ratio 3.29, P = 0.006). Participants' self confidence increased significantly (P < 0.001) across all areas. Actor patients' ratings of participants' communication showed significant improvements for 12/15 key items.


CONCLUSIONS
This intensive 8 hour intervention significantly improved participants' confidence and competence when communicating about randomised clinical trials.
Jenkins
V
V
Sussex Psychosocial Oncology Group, Brighton & Sussex Medical School, University of Sussex, Brighton BN1 9QG. val@sussex.ac.uk
Fallowfield
L
L
Solis-Trapala
I
I
Langridge
C
C
Farewell
V
V
D002983:Clinical Competence / Q000592:standards*; D003142:Communication; D004502:Education, Medical, Continuing / Q000592:standards*; D005260:Female; D006282:Health Personnel / Q000193:education*; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000628:therapy*; D010353:Patient Education as Topic / Q000592:standards*; D010817:Physician-Patient Relations; D015397:Program Evaluation; D016032:Randomized Controlled Trials as Topic; D013664:Teaching Materials; D006113:United Kingdom; D014743:Videotape Recording