Tailoring communication in cancer genetic counseling through individual video-supported feedback: a controlled pretest-posttest design.
OBJECTIVE
To assess the influence of a 1-day individual video-feedback training for cancer genetic counselors on the interaction during initial visits. Feedback was intended to help counselors make counselees' needs more explicit and increase counselors' sensitivity to these.


METHODS
In total 158 counselees, mainly referred for breast or colon cancer and visiting 1 of 10 counselors, received a pre- and post-visit questionnaire assessing needs (fulfillment). Visits were videotaped, counselor eye gaze was assessed, and verbal communication was analyzed by Roter Interaction Analysis System (RIAS) adapted to the genetic setting. Halfway the study, five counselors were trained.


RESULTS
Trained counselors provided more psychosocial information, and with trained counselors emotional consequences of DNA-testing was more often discussed. Counselees seen by a trained counselor considered their need for explanations on (emotional) consequences of counseling as better fulfilled. Unexpectedly, counselees' contribution to the interaction was smaller with trained counselors.


CONCLUSIONS
Feedback appeared to result in greater emphasis on psychosocial issues, without lengthening the visit. However, counselors did not become more verbally supportive in other ways than by providing information.


CONCLUSIONS
A 1 day individual training appears effective to some extend; increased opportunities for watching and practicing behavioral alternatives and arranging consolidating sessions may improve training results.
Pieterse
Arwen H
AH
NIVEL (Netherlands Institute for Health Services Research), P.O. Box 1568, 3500 BN Utrecht, The Netherlands. a.pieterse@nivel.nl
van Dulmen
Alexandra M
AM
Beemer
Frits A
FA
Ausems
Margreet G E M
MG
Bensing
Jozien M
JM
D000328:Adult; D001294:Attitude to Health; D002983:Clinical Competence / Q000592:standards; D003142:Communication; D004502:Education, Medical, Continuing / Q000379:methods*; D004509:Education, Nursing, Continuing / Q000379:methods*; D030141:Feedback, Psychological; D005260:Female; D005817:Genetic Counseling / Q000379:methods / Q000523:psychology; D006801:Humans; D008297:Male; D020380:Needs Assessment; D009369:Neoplasms / Q000235:genetics* / Q000517:prevention & control; D009426:Netherlands; D009730:Nursing Assessment; D015402:Nursing Education Research; D011369:Professional-Patient Relations; D015397:Program Evaluation; D012944:Social Support; D011795:Surveys and Questionnaires; D013663:Teaching / Q000379:methods; D014705:Verbal Behavior; D014743:Videotape Recording / Q000379:methods*