A complex communication skills training program for physicians providing advanced cancer care – content development and barriers and solutions for implementation.

EDUCATION of physicians; NURSING education; ONCOLOGY nursing; LECTURE method in teaching; ONLINE education; NATIONAL competency-based educational tests; PROFESSIONAL practice; EVALUATION of human services programs; FOCUS groups; HOSPITAL medical staff; TEACHING methods; NURSES' attitudes; COURSE evaluation (Education); PALLIATIVE care nurses; INTERVIEWING; PATIENT-centered care; PHYSICIANS' attitudes; COLLEGE teacher attitudes; EVIDENCE-based medicine; HUMAN services programs; QUESTIONNAIRES; RESEARCH funding; DESCRIPTIVE statistics; SCALE analysis (Psychology); CLINICAL competence; CURRICULUM planning; INTEGRATED health care delivery; INFORMATION needs; NEEDS assessment; COMMUNICATION education; CANCER patient medical care; ONCOLOGY; ONCOLOGISTS; PALLIATIVE treatment; REFLECTION (Philosophy)

Background: Early integration of oncology and patient-centered palliative care is the recommended clinical practice model for patients with advanced cancer. General and specific communication skills are necessary to achieve integrated patient-centered care, but require organized training to be adequately mastered. Challenges and barriers on several levels, i.e. organizational, professional and individual may, however, hamper implementation. The development, implementation, and evaluation of such an educational program focusing on communication skills contain many steps, considerations and lessons learned, which are described in this article. Methods: A multi-professional faculty developed, implemented, and evaluated an educational program through a 5-step approach. The program was part of a Norwegian cluster-randomized controlled trial aiming to test the effect of early integration of oncology and palliative care for patients with advanced cancer. Results: The result is the PALLiON educational program; a multi-faceted, evidence-based, and learner-centered program with a specific focus on physicians' communication skills. Four modules were developed: lectures, discussion groups, skills training, and coaching. These were implemented at the six intervention hospitals using different teaching strategies. Evaluation in a subgroup of participants showed a positive appraisal of the group discussions and skills training. Conclusion:We present our experiences and reflections regarding implementation and lessons learned, which should be considered in future developments and implementations; (1) Include experienced faculty with various backgrounds, (2) Be both evidence-based and learner-centered, (3) Choose teaching strategies wisely, (4) Expect resistance and skepticism, (5) Team up with management and gatekeepers, (6) Expect time to fly, and (7) Plan thorough assessment of the evaluation and effect. Trial registration: ClinicalTrials.gov identifier: NCT03088202. [ABSTRACT FROM AUTHOR]

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