JCO oncology practice · 2026
Enhancing Goal-Concordant Care in Oncology: Development and Impact of an Institutional Communication Skills Training Program.
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Bitar Heather N, Leitner Andrew T, Dale William, Mecusker Eric D, Jun Christine S, Ramirez Carey, Liou Eleana, Razavi Marianne, Ferrell Betty, Ekaputri Stella, Buga Sorin, Baecker Jennifer S, Luna Joanna, Kaur Navneet, Zachariah Finly
Аннотация
PURPOSE: As part of the Alliance of Dedicated Cancer Centers' Improving Goal-Concordant Care (IGCC) initiative, we developed and delivered virtual communication skills training (CST) series to improve the quality of serious illness communication and goal-concordant care (GCC) targeting hematologists, medical oncologists, and advanced practice providers (APPs).
METHODS: The CST included two live-virtual workshops: (1) communication frameworks for GCC and difficult conversations and (2) advance care planning (ACP), including documentation and billing. Workshops incorporated didactics, interactive case discussions, role-play exercises, and training in electronic health record documentation and ACP billing. Clinician confidence and feedback were assessed via postworkshop evaluations. Patient-reported experience was assessed using the heard and understood (HAU) scale from Press Ganey surveys. Pre-/post-training changes in top-box HAU scores were analyzed via paired t-tests and mixed-effects modeling.
RESULTS: Ninety-three clinicians completed the training evaluation for workshop 1, and 98 completed the evaluation for workshop 2. Over 75% of participants rated content as good or outstanding, with strong gains in self-reported confidence in using ACP tools, Physicians Orders for Life-Sustaining Treatment (POLST) forms, billing codes, and the SPIKES protocol to deliver difficult news. Compared with pretraining scores, physicians demonstrated significant improvement in overall patient-reported HAU scores (79.46 v 83.77, P = .002), particularly for patient perception of being HAU (78.04 v 83.27, P = .012). APPs had higher baseline scores than physicians (90.74 v 78.04, P < .001), with no significant change post-training.
CONCLUSION: Our IGCC CST series improved clinician-reported confidence in applying the learned skills and enhanced patient-reported communication quality among physicians, supporting broader implementation of the training program to strengthen serious illness communication in oncology care.
METHODS: The CST included two live-virtual workshops: (1) communication frameworks for GCC and difficult conversations and (2) advance care planning (ACP), including documentation and billing. Workshops incorporated didactics, interactive case discussions, role-play exercises, and training in electronic health record documentation and ACP billing. Clinician confidence and feedback were assessed via postworkshop evaluations. Patient-reported experience was assessed using the heard and understood (HAU) scale from Press Ganey surveys. Pre-/post-training changes in top-box HAU scores were analyzed via paired t-tests and mixed-effects modeling.
RESULTS: Ninety-three clinicians completed the training evaluation for workshop 1, and 98 completed the evaluation for workshop 2. Over 75% of participants rated content as good or outstanding, with strong gains in self-reported confidence in using ACP tools, Physicians Orders for Life-Sustaining Treatment (POLST) forms, billing codes, and the SPIKES protocol to deliver difficult news. Compared with pretraining scores, physicians demonstrated significant improvement in overall patient-reported HAU scores (79.46 v 83.77, P = .002), particularly for patient perception of being HAU (78.04 v 83.27, P = .012). APPs had higher baseline scores than physicians (90.74 v 78.04, P < .001), with no significant change post-training.
CONCLUSION: Our IGCC CST series improved clinician-reported confidence in applying the learned skills and enhanced patient-reported communication quality among physicians, supporting broader implementation of the training program to strengthen serious illness communication in oncology care.