title: Can consultation skills training change doctors' behaviour to increase involvement of patients in making decisions about standard treatment and clinical trials: a randomized controlled trial.
abstract: BACKGROUND
  Informed consent is required for both standard cancer treatments and experimental cancer treatments in a clinical trial. Effective and sensitive physician-patient communication about informed consent is difficult to achieve. Our aim was to train doctors in clear, collaborative and ethical communication about informed consent and evaluate the impact of training on doctor behaviour, stress and satisfaction.
  
  
  METHODS
  Participants were 21 oncologists from 10 Australian/New Zealand (ANZ) centres and 41 oncologists from 10 Swiss/German/Austrian (SGA) centres. Oncologists were randomized to participate in a 1-day workshop or not. Patients were recruited before and after the training. Doctors were asked to submit 1-2 audiotaped consultations before and after training. Doctors completed outcome measures before and after completing the post-training cohort recruitment.
  
  
  RESULTS
  Ninety-five consultation interactions were audiotaped. Doctors strongly endorsed the training. ANZ intervention doctors demonstrated a significant increase in collaborative communication (P = 0.03). There was no effect of training on other doctor behaviours. Trained doctors did not demonstrate reduced stress and burnout. Patient outcomes are presented elsewhere.
  
  
  CONCLUSIONS
  Training can improve some aspects of the process of obtaining informed consent. Methods to increase the impact of training are required and may include longer training and more intensive follow-up.
authors: Centre for Medical Psychology and Evidence-based Decision-Making (CeMPED), University of Sydney, Sydney, NSW, Australia.
authors: P
authors: P
authors: Butow
authors: Department of Social and Behavioral Health, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA.
authors: R
authors: R
authors: Brown
authors: International Breast Cancer Study Group (IBCSG) Statistical Centre, Department of Biostatistics & Computational Biology, Dana-Farber Cancer Institute, Boston, MA, USA.
authors: J
authors: J
authors: Aldridge
authors: Centre for Medical Psychology and Evidence-based Decision-Making (CeMPED), University of Sydney, Sydney, NSW, Australia.
authors: I
authors: I
authors: Juraskova
authors: Quality of Life Office, IBCSG Coordinating Center and Department of Medical Oncology, Inselspital, Bern University Hospital, Bern, Switzerland.
authors: P
authors: P
authors: Zoller
authors: Pam McLean Centre, Northern Clinical School, University of Sydney, Sydney, NSW, Australia.
authors: F
authors: F
authors: Boyle
authors: Department of Social and Behavioral Health, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA.
authors: M
authors: M
authors: Wilson
authors: Quality of Life Office, IBCSG Coordinating Center and Department of Medical Oncology, Inselspital, Bern University Hospital, Bern, Switzerland.
authors: J
authors: J
authors: Bernhard
mesh_terms: D001943:Breast Neoplasms / Q000628:therapy; D002983:Clinical Competence; D003142:Communication; D004493:Education; D004502:Education, Medical, Continuing; D005260:Female; D006801:Humans; D007258:Informed Consent / Q000523:psychology; D008297:Male; D008875:Middle Aged; D010358:Patient Participation; D018579:Patient Selection; D010817:Physician-Patient Relations; D012017:Referral and Consultation; D013637:Tape Recording
keywords: clinical trials; consultation skills training; decision making; oncology; physician behaviour; randomized controlled trial