Clinician-Patient Communication in Lung Cancer Care

Active, not recruiting

• Conditions: Lung Cancer
• Interventions: Behavioral: Questionnaire; Behavioral: Audio recordings of clinical consultations; Behavioral: 2-hour empathic communication skills training; Behavioral: Patient Interview; Behavioral: Standardized Patient Assessments; Behavioral: Training evaluation; Behavioral: Patient recruitment

• Registration Number: NCT02732834
• Lead Sponsor: Memorial Sloan Kettering Cancer Center

Brief Summary

The purpose of this study is to better understand communication between patients with lung cancer and their clinicians. The investigators are also interested in patient's perceptions of the quality of communication with his/her clinician and how these perceptions may impact patient outcomes. The clinician participating in this study and has given us permission to approach his/her eligible patients for study participation.

Detailed Description

Not available

Study Timeline

• Study Start: 2016-01
• Study First Submitted: 2016-03-14
• Study First Submitted QC: 2016-04-04
• Study First Posted: 2016-04-11
• Status Verified: 2024-02
• Last Update Submitted: 2024-02-01
• Last Update Posted: 2024-02-02
• Primary Completion: 2025-01
• Study Completion: 2025-01

Recruitment & Eligibility

• Status: ACTIVE_NOT_RECRUITING
• Sex: All
• Target Recruitment: 294

Inclusion Criteria

• Patients with confirmed lung cancer diagnosis or mass suspicious of lung cancer as per clinician report and/or EMR
• Lung cancer diagnosis or suspicious mass as per clinician report/EMR within 0-6 months of consent or within no more than three visits to participating clinician
• Participating clinician approves his/her patient's participation in this study per clinician report.
• Former (at least 100 cigarettes in lifetime and quit more than 30 days prior to enrollment) or current smoker (lifetime smoker who reports cigarette smoking within the past 30 days) as per self report or EMR;
• English fluency (determined through EMR or clinician report), as we do not have the resources to translate the consultations from other languages or the surveys to other languages;
• Patients must be 18 years old or older

Clinician Inclusion Criteria:

• An MSK attending physician (radiologists, medical oncologists, and surgeons), Nurse Practitioner (NP), Physician Assistant (PA), Fellow, Resident or Clinical Nurse Specialist (CNS) or Clinical Nurse (RN) who is a member of the Thoracic Disease Management Team or Pulmonary Service currently treating thoracic patients at MSK as per self report
• Clinical has individual clinic consultations to discuss adult health assessment and/or smoking history with the target patient population: English-speaking, at least 18 years of age, has a suspicious lung mass or confirmed diagnosis, is a former/current smoker, has had no more than 3 visits with clinician or had diagnosis in past 6 months as per self-report.

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Exclusion Criteria

Clinician Exclusion Criteria

• N/A

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Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
Part 1: Lung patients	Patient Interview	Following informed consent, the patient will complete the patient questionnaire, either electronically, by phone, or on paper. Patients who prefer to complete the survey electronically will be emailed a link to access to a secure electronic (web-based) version of the study assessment which they will have access to from any computer. We will include an introductory email with the survey link. Will audio-record actual patient-physician clinical consultations with lung cancer patients at Memorial Sloan Kettering (MSK). Completing the survey will take about 15 minutes. Answer a few open-ended questions about the consultation with the doctor. We will audio record your answers to these questions. This will take about 15 minutes.
Part 2: Lung patients	Questionnaire	Following informed consent, the patient will complete the patient questionnaire, either electronically, by phone, or on paper. Patients who prefer to complete the survey electronically will be emailed a link to access to a secure electronic (web-based) version of the study assessment which they will have access to from any computer. Completing the survey will take about 15 minutes.
Part 2: Thoracic and pulmonary clinicians	Standardized Patient Assessments	Following informed consent, clinicians will be scheduled to participate in a 2 hour training on empathic communication with lung cancer patients. Surveys will be collected from 6 patients (3 pre-training, 3 post-training). Clinicians will complete one standardized patient assessment before training (pre-SPA) and one assessment after training (post-SPA). These are 12-minute video-recorded clinic consultations with standardized patients (trained actors).
Part 1: Lung patients	Questionnaire	Following informed consent, the patient will complete the patient questionnaire, either electronically, by phone, or on paper. Patients who prefer to complete the survey electronically will be emailed a link to access to a secure electronic (web-based) version of the study assessment which they will have access to from any computer. We will include an introductory email with the survey link. Will audio-record actual patient-physician clinical consultations with lung cancer patients at Memorial Sloan Kettering (MSK). Completing the survey will take about 15 minutes. Answer a few open-ended questions about the consultation with the doctor. We will audio record your answers to these questions. This will take about 15 minutes.
Part 1: Thoracic physicians and clinicians	Audio recordings of clinical consultations	Will have 5 visits/consultations with their patients audio recorded.
Part 2: Thoracic and pulmonary clinicians	2-hour empathic communication skills training	Following informed consent, clinicians will be scheduled to participate in a 2 hour training on empathic communication with lung cancer patients. Surveys will be collected from 6 patients (3 pre-training, 3 post-training). Clinicians will complete one standardized patient assessment before training (pre-SPA) and one assessment after training (post-SPA). These are 12-minute video-recorded clinic consultations with standardized patients (trained actors).
Part 2: Thoracic and pulmonary clinicians	Patient recruitment	Following informed consent, clinicians will be scheduled to participate in a 2 hour training on empathic communication with lung cancer patients. Surveys will be collected from 6 patients (3 pre-training, 3 post-training). Clinicians will complete one standardized patient assessment before training (pre-SPA) and one assessment after training (post-SPA). These are 12-minute video-recorded clinic consultations with standardized patients (trained actors).
Part 1: Lung patients	Audio recordings of clinical consultations	Following informed consent, the patient will complete the patient questionnaire, either electronically, by phone, or on paper. Patients who prefer to complete the survey electronically will be emailed a link to access to a secure electronic (web-based) version of the study assessment which they will have access to from any computer. We will include an introductory email with the survey link. Will audio-record actual patient-physician clinical consultations with lung cancer patients at Memorial Sloan Kettering (MSK). Completing the survey will take about 15 minutes. Answer a few open-ended questions about the consultation with the doctor. We will audio record your answers to these questions. This will take about 15 minutes.
Part 2: Thoracic and pulmonary clinicians	Training evaluation	Following informed consent, clinicians will be scheduled to participate in a 2 hour training on empathic communication with lung cancer patients. Surveys will be collected from 6 patients (3 pre-training, 3 post-training). Clinicians will complete one standardized patient assessment before training (pre-SPA) and one assessment after training (post-SPA). These are 12-minute video-recorded clinic consultations with standardized patients (trained actors).

Primary Outcome Measures

Name	Time	Method
Part 1: Systematic coding of clinical encounters and the perceived stigma within the clinical consultation	1 year	interview along with patient-reported data from the post-consultation questionnaire will be used.
Part 1: All variables (stigma, satisfaction with communication, psychological distress)	1 year	will be measured via post-consultation questionnaires
Part 2: We will pilot test the effectiveness of the empathic communication skills training module	1 year	for clinicians: physicians, nurse practitioners, physician assistants, fellows, residents, clinical nurses, and clinical nurse specialists by using the communication skills training module

Secondary Outcome Measures

Name	Time	Method
# of patients referred to MSK's Tobacco Treatment Program (TTP)	1 year	will be determined via review of the medical record and/or Tobacco Treatment Program database

Trial Locations

Locations (7)

Memorial Sloan Kettering Basking Ridge (Consent and follow-up only); 🇺🇸 Basking Ridge, New Jersey, United States

Memorial Sloan Kettering Monmouth (Consent and follow-up only); 🇺🇸 Middletown, New Jersey, United States

Memorial Sloan Kettering Bergen (Consent and follow-up only); 🇺🇸 Montvale, New Jersey, United States

Memorial Sloan Kettering Commack (Consent and follow-up only); 🇺🇸 Commack, New York, United States

Memorial Sloan Kettering Westchester (Consent and follow-up only); 🇺🇸 Harrison, New York, United States

Memorial Sloan Kettering Cancer Center; 🇺🇸 New York, New York, United States

Memorial Sloan Kettering Nassau (Consent and Follow-Up only); 🇺🇸 Uniondale, New York, United States