Implementation of clinical trial communication skills training for oncology fellows.

Effective physician-patient communication about cancer clinical trials (CCTs) is critical for improving participation, particularly in underrepresented populations. Most eligible patients are willing to participate when invited through clear, patient-centered discussions, yet treating oncologists often do not discuss trials or do so ineffectively. Communication skills training is well-suited for the fellowship stage; however, most Hematology/Oncology (Hem-Onc) education programs do not formally teach CCT communication skills. To address this gap, we implemented COMM-CCT, a previously developed CCT communication skills workshop for Hem-Onc fellows and assessed the acceptability and feasibility of its implementation in Hem-Onc fellowship programs. We implemented the COMM-CCT workshop at seven Hem-Onc programs in the U.S. The three-hour, synchronous Zoom-based workshop included a one-hour didactic session that covered barriers to patient trial participation (e.g., patient, physician, institutional) and introduced the COMM-CCT framework (Check-In, Outline Options, Make a Shared Decision, Map Out Next Steps) for discussing CCTs. This was followed by a two-hour role-play session where fellows practiced communication skills with cancer survivors who were trained to act as patients, while faculty facilitators and peers gave constructive feedback. At each site, “fellow champions” encouraged peers to participate in the workshop. We assessed implementation (i.e., feasibility and acceptability) by surveying and interviewing participating fellows. Regarding acceptability, fellows (n=54) reported high satisfaction (on a 1-5 scale) with the workshop (M=4.30, SD=0.79), its content (M=4.28, SD=0.79), its organization and execution (M=4.5, SD=0.61), and the faculty and facilitators (M=4.56, SD=0.63). They were comfortable with communication skills taught (M=4.15, SD=0.71) and felt the skills were compatible with the realities and resources of their clinical practice (M=4.35, SD=0.70). Fellows further agreed what they learned would be useful to (M=4.33, SD=0.73) and able to be incorporated into (M=4.22, SD=0.72) their clinical practice. When interviewed, fellows (n=9) found the workshop acceptable, describing it as “well-organized,” “very helpful,” and relevant. The role-plays with “real survivors” were noted as a strength, as was learning by observation in a group setting. Feasibility was evidenced by fellows reporting incorporating COMM-CCT concepts into practice, such as by initiating discussions with patients about cancer clinical trials since participating in the workshop. The COMM-CCT workshop is acceptable and feasible to implement in Hem-Onc fellowship programs. Findings will inform its refinement, broader scaling, and continued integration into graduate medical education programs.

Duke Scholars

Author Andrea Sitlinger Medicine, Hematologic Malignancies and Cellular Therapy