title: Working alliance in communication skills training for oncology clinicians: a controlled trial.
abstract: OBJECTIVE
  The aim of this study was to evaluate the impact of communication skills training (CST) on working alliance and to identify specific communicational elements related to working alliance.
  
  
  METHODS
  Pre- and post-training simulated patient interviews (6-month interval) of oncology physicians and nurses (N=56) who benefited from CST were compared to two simulated patient interviews with a 6-month interval of oncology physicians and nurses (N=57) who did not benefit from CST. The patient-clinician interaction was analyzed by means of the Roter Interaction Analysis System (RIAS). Alliance was measured by the Working Alliance Inventory - Short Revised Form.
  
  
  RESULTS
  While working alliance did not improve with CST, generalized linear mixed effect models demonstrated that the quality of verbal communication was related to alliance. Positive talk and psychosocial counseling fostered alliance whereas negative talk, biomedical information and patient's questions diminished alliance.
  
  
  CONCLUSIONS
  Patient-clinician alliance is related to specific verbal communication behaviors.
  
  
  CONCLUSIONS
  Working alliance is a key element of patient-physician communication which deserves further investigation as a new marker and efficacy criterion of CST outcome.
authors.affiliation: Department of Psychiatry, Lausanne University Hospital, CH-1011 CHUV-Lausanne, Switzerland.
authors.forename: Claudia
authors.initials: C
authors.lastname: Meystre
authors.forename: Céline
authors.initials: C
authors.lastname: Bourquin
authors.forename: Jean-Nicolas
authors.initials: JN
authors.lastname: Despland
authors.forename: Friedrich
authors.initials: F
authors.lastname: Stiefel
authors.forename: Yves
authors.initials: Y
authors.lastname: de Roten
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003142:Communication; D003299:Cooperative Behavior; D003376:Counseling / Q000193:education; D006801:Humans; D007318:Inservice Training / Q000379:methods*; D007400:Interprofessional Relations; D007407:Interviews as Topic; D016014:Linear Models; D008495:Medical Oncology / Q000193:education*; D008875:Middle Aged; D009723:Nurse-Patient Relations; D009726:Nurses; D016544:Patient Simulation; D010817:Physician-Patient Relations; D010820:Physicians; D011795:Surveys and Questionnaires