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Efficacy of a Cancer Research UK communication skills training model for oncologists: a randomised controlled trial
Open accessAbstract
Background Doctors' communication with patients is commonly hampered by lack of training in this core skill. This study aimed to assess the efficacy of an intensive 3-day training course on communication skills in a randomised controlled trial with a two-by-two factorial design and several outcomes.Methods 160 oncologists from 34 UK cancer centres were randomly allocated to four groups: written feedback followed by course; course alone; written feedback alone; and control. At each of two assessment periods, consultations with six to ten consecutive, consenting patients per doctor were videotaped. 2407 patients participated. Outcome measures included objective and subjective ratings made by researchers, doctors, and patients. The primary outcomes were objective improvements after the intervention in key communication skills. Course content included structured feedback, videotape review of consultations, role-play with simulated patients, interactive group demonstrations, and discussion led by a trained facilitator.Findings In Poisson regression analysis of counts of communication behaviours, course attendance significantly improved key outcomes. The estimated effect sizes corresponded to higher rates of use of focused questions (difference between course attenders [n=80] and non-attenders [n=80] 34%, p=0.003), focused and open questions (27%, p=0.005), expressions of empathy (69%, p=0.003), and appropriate responses to patients' cues (38%, p=0.026), and a 24% lower rate of use of leading questions (p=0.11). There was little evidence for the effectiveness of written feedback.Interpretation The communication problems of senior doctors working in cancer medicine are not resolved by time and clinical experience. This trial shows that training courses significantly improve key communication skills. More resources should be allocated to address doctors' training needs in this vital area.
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“In medical education, it is crucial for students to gain extensive exposure to real-world clinical scenarios3,4.”
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“Research has shown that communication workshops with simulations of real-life clinical situations through role-plays, interactive practices, discussions, feedbacks, or self-debrief may be more useful in improving skills [5,22] and reducing burnout in HCP than traditional lecture-based teaching [2,14].”
From The efficacy of applying the Interpersonal Effectiveness skills of dialectical behavior therapy into communication skills workshop for clinical nurses (2023) · cites this paper as [22]
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“Outcome data were complete in only six studies (Brown 2001; Fallowfield 2002; Ho 2008; Robins 1989; Song 2005; Thom 1999 ).”
From Interventions for providers to promote a patient-centred approach in clinical consultations (2012) · cites this paper as Fallowfield 2002
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“Only five studies appeared to be at high risk of bias from selective reporting (Alamo 2002; Clark 2000; Fallowfield 2002; Haskard 2008; Pill 1998).”
From Interventions for providers to promote a patient-centred approach in clinical consultations (2012) · cites this paper as Fallowfield 2002
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Metadata
- Authors
- Fallowfield, L., Jenkins, V., Farewell, V., Saul, J., Duffy, A., & Eves, R.
- Affiliations
- University of Sussex (GB)
- Corresponding author
- Fallowfield, Lesley
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 2002-02
- Volume
- 359
- Issue
- 9307
- Pages
- 650-656
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- OpenAlex
- W2141791438
- Cited by
- 854
- References
- 24
- Citations by year
- 2026: 13 · 2025: 17 · 2024: 26 · 2023: 21 · 2022: 27 · 2021: 31 · 2020: 28 · 2019: 30 · 2018: 28 · 2017: 43 · 2016: 36 · 2015: 25 · 2014: 36 · 2013: 48 · 2012: 50
- FWCI
- 93.04
- Type
- journal article
- Language
- en
- Open access
- green
- figshare.com
- Licence
- Locations
- The Lancet (publishedVersion)
- PubMed (publishedVersion)
- Figshare (submittedVersion, cc-by)
- Funders
- Cancer Research UK
- Topics
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Social Sciences › Education › Innovations in Medical Education
- Health Sciences › Medicine › Psychiatry and Mental health › Empathy and Medical Education
- Keywords
- physician-patient communication, communication skills training, oncologists, written feedback, videotape review, role play, empathy, leading questions, physician training
- MeSH terms
- Adult, Clinical Competence, Communication, Competency-Based Education, Female, United Kingdom, Humans, Male, Medical Oncology, Physician-Patient Relations, Prospective Studies, Quality of Health Care, Regression Analysis, Odds Ratio
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