Effects of On-Site Supportive Communication Training in Oncology: A Multicenter Randomized Trial Assessing >3500 Patient Experiences.

To evaluate the effect of On-site Supportive Communication Training (On-site SCT) on patient-rated doctor communication in outpatient oncology. In this Danish multicenter randomized trial, 89 oncology doctors were assigned to On-site SCT or usual practice. The intervention included three training days over 3-4 months with real-time observation, structured reflection, and individualized feedback integrated into routine consultations. Patients attending baseline and follow-up consultations completed the validated 14-item Communication Assessment Tool (CAT). The proportion of patients rating doctor communication as "excellent" was the prespecified primary outcome. Of 3,989 patients, 3,562 completed the questionnaire. Core interpersonal behaviors were rated highly (68-73% "excellent"), while active engagement behaviors - eliciting patient ideas (69%), checking understanding (61%), and encouraging questions (58%) - were lower. No significant differences were observed between groups. On-site SCT did not improve patient-rated communication but identified priorities for future communication training. High baseline communication ratings and resulting ceiling effects may have limited detection of intervention effects. The study provides a large multicenter benchmark for PREMs and underscores methodological challenges in evaluating communication interventions.