CURRENT STATUS AND FUTURE DIRECTION OF COMMUNICATION SKILL TRAINING PROGRAM

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Abstract

Current communication skill training utilizes role-playing with ‘bad news telling’ protocol, and significant improvement in clinician's self-efficacy has been reported. Recent randomized trial clearly demonstrated that early palliative care integrated with standard oncologic care improves the outcomes of patients with metastatic non-small-cell lung cancer compared with standard oncologic care alone (Temel et al. N Engl J Med 2010; 363: 733–742). In the study, the palliative care team paid specific attention to assessing physical and psychosocial symptoms control, establishing goals of care, assisting with decision-making regarding treatment, and coordinating care on the basis of the individual needs of the patient. As a result, more patients assigned to early palliative care had an accurate assessment of their prognosis over time. Patients receiving early palliative care who reported an accurate perception of their prognosis were less likely to receive intravenous chemotherapy near the end of life. These findings are strong evidence that quality of oncologic care depend on patients' perception of the disease and prognosis, physical, and psychosocial symptoms control. Because several options are available in the current oncologic care, optimum decision-making is critically important. Future communication skill training challenges include discussing prognosis, assisting with decision-making and working as a multidisciplinary team. More medical oncologists should participate as facilitator in communication skill training program.

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