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Studying communication in oncologist-patient encounters: The SCOPE Trial

Department of Medicine and Center for Palliative Care, Duke University Medical Center, Durham, korop001{at}mc.duke.edu

Kathryn I Pollak

Department of Community and Family Medicine and Duke Comprehensive Cancer Center, Duke University Medical Center, Durham

Robert M Arnold

Department of Medicine, University of Pittsburgh Cancer Institute, Pittsburgh and Institute for Doctor-Patient Communication and Institute to Enhance Palliative Care, University of Pittsburgh School of Medicine, Pittsburgh

Stewart C Alexander

Department of Medicine and Center for Palliative Care, Duke University Medical Center, Durham and Center for Health Services Research, Durham VA Medical Center, Durham

Celette Sugg Skinner

Duke Comprehensive Cancer Center, Duke University Medical Center, Durham

Maren K Olsen

Center for Health Services Research, Durham VA Medical Center, Durham and Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham

Amy S Jeffreys

Center for Health Services Research, Durham VA Medical Center, Durham

Keri L Rodriguez

Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, and Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh

Amy P Abernethy

Department of Medicine and Center for Palliative Care and Duke Comprehensive Cancer Center, Duke University Medical Center, Durham

James A Tulsky

Department of Medicine and Center for Palliative Care and Duke Comprehensive Cancer Center, Duke University Medical Center, Durham and Center for Health Services Research, Durham VA Medical Center, Durham

Study objective: Most oncologists have not received adequate training in physician-patient communication, and existing effective courses tend to be time and resource intensive. We are developing and testing a tailored CD-ROM educational intervention that includes feedback on oncologists’ own audio-recorded conversations with their advanced cancer patients. In this report, we describe the study methods and identify challenges to implementation and how these were overcome.

Study design: A three-phase, randomized, controlled trial. In Phase 1, we audio-recorded oncologist-patient clinic encounters. In Phase 2, oncologists were randomly assigned to a communication CD-ROM intervention or control. Phase 3 consisted of audio-recording all participating oncologists conversing with a new sample of patients, two to 12 months after the intervention, to assess its effectiveness.

Setting: Oncology clinics at Duke University Medical Center (DUMC) and the Durham Veterans Affairs Medical Center (DVAMC) in Durham, NC, and the University of Pittsburgh Medical Center (UPMC) in Pittsburgh, PA.

Participants: Medical, radiation and gynecological oncologists and their patients with advanced cancer.

Intervention: A tailored CD-ROM that contains an interactive educational interface with reference materials and video-clips of model conversations, along with the oncologists’ own Phase 1 audio-recorded conversations.

Conclusion: We present challenges and solutions to oncologist recruitment, identifying appropriate patients with advanced cancer, adapting to clinic flow, and developing a self-administered communications intervention.

Key Words: patient-provider relationship • physician-patient communication • oncologist

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				K. I. Pollak, R. M. Arnold, A. S. Jeffreys, S. C. Alexander, M. K. Olsen, A. P. Abernethy, C. Sugg Skinner, K. L. Rodriguez, and J. A. Tulsky Oncologist Communication About Emotion During Visits With Patients With Advanced Cancer J. Clin. Oncol., December 20, 2007; 25(36): 5748 - 5752. [Abstract] [Full Text] [PDF]