title: Effect of individualized communication skills training on physicians' discussion of clinical trials in oncology: results from a randomized controlled trial.
abstract: BACKGROUND
  Discussing randomized clinical trials (RCTs) with cancer patients is one of the most challenging communication tasks a physician faces. Only two prior Communication Skills Trainings (CSTs) focused on RCTs in oncology have been reported. Their results demonstrated the need for further improvement. We developed and evaluated an enhanced, individually-tailored CST focused on improving physicians' communication during discussions of RCTs.
  
  
  METHODS
  The CST focused on personal learning goals derived from video pre-assessment that were addressed in a 1.5-day group workshop and one-on-one coaching sessions. Forty physicians were recruited and randomly assigned to intervention and control groups. Video-recorded standardized consultations with actor-patients were utilized. As a primary outcome (1), training success was evaluated by blinded raters using a previously developed checklist. Change in checklist items was evaluated between pre- and post-training assessment and compared against control group results. As a secondary outcome (2), the physicians' feeling of confidence was assessed by a questionnaire.
  
  
  RESULTS
  (1) Significant improvements in the intervention group were observed for the score on all items (p = 0.03), for the subgroup of content-specific items (p = 0.02), and for the global rating of communication competence (p = 0.04). The improvement observed for the subgroup of general communication skill items did not achieve significance (p = 0.20). (2) The feeling of confidence improved in nine out of ten domains.
  
  
  CONCLUSIONS
  While the individually-tailored CST program significantly improved the physicians' discussions of RCTs, specifically related to discussion content, what remains unknown is the influence of such programs in practice on participant recruitment rates. The study was registered retrospectively in 2010/07/22 under DRKS-ID: DRKS00000492 .
authors.affiliation: Center for Mental Health, Department of Psychosomatic Medicine and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, Hauptstr. 8, D-79104, Freiburg, Germany. alexander.wuensch@uniklinik-freiburg.de.|Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, Langerstrasse 3, D-81675, Munich, Germany. alexander.wuensch@uniklinik-freiburg.de.
authors.forename: Alexander
authors.identifier: http://orcid.org/0000-0003-4893-290X
authors.initials: A
authors.lastname: Wuensch
authors.affiliation: Department of Internal Medicine I (Hematology and Oncology), Medical Center - University of Freiburg, Faculty of Medicine, Hugstetterstr. 55, D-79106, Freiburg, Germany.|Center for Pediatrics, Department of General Pediatrics, Adolescent Medicine and Neonatology, Medical Center - University of Freiburg, Faculty of Medicine, Mathildenstr.1, D-79106, Freiburg, Germany.
authors.forename: Tanja
authors.initials: T
authors.lastname: Goelz
authors.affiliation: Clinical Trials Unit (CTU), Medical Center - University of Freiburg, Faculty of Medicine, Elsaesser Str. 2, D-79110, Freiburg, Germany.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Ihorst
authors.affiliation: Center for Family Research, University of Georgia, 1095 College Station Rd, Athens, GA, 30602, USA.
authors.forename: Darcey D
authors.initials: DD
authors.lastname: Terris
authors.affiliation: Department of Internal Medicine I (Hematology and Oncology), Medical Center - University of Freiburg, Faculty of Medicine, Hugstetterstr. 55, D-79106, Freiburg, Germany.
authors.forename: Hartmut
authors.initials: H
authors.lastname: Bertz
authors.affiliation: Institute of Psychology, Department Rehabilitation Psychology and Psychotherapy, Albert-Ludwigs-University Freiburg, Engelbergerstr. 41, D-79106, Freiburg, Germany.
authors.forename: Juergen
authors.initials: J
authors.lastname: Bengel
authors.affiliation: Center for Mental Health, Department of Psychosomatic Medicine and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, Hauptstr. 8, D-79104, Freiburg, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Wirsching
authors.affiliation: Center for Mental Health, Department of Psychosomatic Medicine and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, Hauptstr. 8, D-79104, Freiburg, Germany.
authors.forename: Kurt
authors.initials: K
authors.lastname: Fritzsche
mesh_terms: D003142:Communication; D004502:Education, Medical, Continuing; D006801:Humans; D007318:Inservice Training; D008495:Medical Oncology / Q000193:education*; D009369:Neoplasms / Q000523:psychology; D018802:Patient-Centered Care; D010817:Physician-Patient Relations; D011897:Random Allocation; D016032:Randomized Controlled Trials as Topic / Q000523:psychology
keywords: CST; Communication skills training; Informed consent; Oncology; Randomized clinical trials