***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND AND PURPOSE Optimizing communication between radiotherapy team members and patients and between colleagues requires training . This study applies a r and omized controlled design to assess the efficacy of a 38-h communication skills training program . MATERIAL AND METHODS Four radiotherapy teams were r and omly assigned either to a training program or to a waiting list . Team members ' communication skills and their self-efficacy to communicate in the context of an encounter with a simulated patient were the primary endpoints . These encounters were scheduled at the baseline and after training for the training group , and at the baseline and four months later for the waiting list group . Encounters were audiotaped and transcribed . Transcripts were analyzed with content analysis software ( LaComm ) and by an independent rater . RESULTS Eighty team members were included in the study . Compared to untrained team members , trained team members used more turns of speech with content oriented toward available re sources in the team ( relative rate [RR]=1.38 ; p=0.023 ) , more assessment utterances ( RR=1.69 ; p<0.001 ) , more empathy ( RR=4.05 ; p=0.037 ) , more negotiation ( RR=2.34 ; p=0.021 ) and more emotional words ( RR=1.32 ; p=0.030 ) , and their self-efficacy to communicate increased ( p=0.024 and p=0.008 , respectively ) . CONCLUSIONS The training program was effective in improving team members ' communication skills and their self-efficacy to communicate in the context of an encounter with a simulated patient . Future study should assess the effect of this training program on communication with actual patients and their satisfaction . Moreover a cost-benefit analysis is needed , before implementing such an intensive training program on a broader scale BACKGROUND AND PURPOSE The aim of this study was to assess the efficacy of a 38-h communication skills training program design ed for multidisciplinary radiotherapy teams . MATERIAL S AND METHODS Four radiotherapy teams were r and omly assigned to a training program or to a waiting list . Assessment s were scheduled at baseline ( T1 ) and then after the training was completed or four months later ( T2 ) , respectively . Communication around radiotherapy delivery was assessed based on audio recordings of the first and last radiotherapy sessions in order to assess team members ' communication skills and the expression of concerns by breast cancer patients ( analyzed with content analysis software LaComm ) . RESULTS 198 radiotherapy sessions were recorded . During the first radiotherapy sessions , members of the trained teams exhibited more assessment skills ( p=0.048 ) , provided more setting information ( p<0.001 ) , and used more social words ( p=0.019 ) compared to the members of the untrained teams . During the last radiotherapy session , members of the trained teams used more assessment skills ( p=0.004 ) and patients interacting with members of the trained teams expressed more sadness words ( p=0.023 ) . CONCLUSION Training of multidisciplinary teams has the potential to transfer skills that affect the short exchanges that take place around radiotherapy delivery Purpose Although patients receive information prior to commencing radiotherapy , they often experience anxiety and distress . We conducted a pilot r and omised controlled trial to determine whether a radiation therapist led psycho-educational intervention for breast cancer patients prior to radiotherapy is likely to be effective in reducing radiotherapy-related concerns , patient anxiety and depression . Methods The intervention comprised two face-to-face consultations with a radiation therapist ( one prior to radiation planning and the other prior to treatment ) . Patients completed surveys at baseline , prior to treatment planning and on the first day of treatment . Outcome measures included the Hospital Anxiety and Depression Scale , Radiation Therapy Related Patient Concerns and Radiation Therapy Knowledge Scales . Results One hundred and twenty two patients completed baseline measures . Fifty-eight patients received usual care , and 64 received the intervention .  After the first consultation , patient anxiety was significantly lower in the intervention group ( p = 0.048 ) , as were concerns about radiotherapy ( p = 0.001 ) . There were no differences between groups for depression . Patient knowledge for the intervention group was higher after the first consultation ( p < 0.001 ) . Conclusion This intervention is likely to be effective in reducing patient anxiety and concerns and increasing knowledge . Future research is required to test this intervention with a larger population Aim : To describe the development of the content and pilot testing of a radiation therapist‐led educational intervention for breast cancer patients about to commence radiotherapy .  Pilot testing consisted of testing the intervention for appropriateness , feasibility and acceptance OBJECTIVE Recent studies have recognised that the communication skills learned in the training environment are not always transferred back into the clinical setting . This paper reports a study which investigated the potential of clinical supervision in enhancing the transfer process . METHODS A r and omised controlled trial was conducted involving 61 clinical nurse specialists . All attended a 3-day communication skills training workshop .  Twenty-nine were then r and omised to 4 weeks of clinical supervision  , aim ed at facilitating transfer of newly acquired skills into practice . Assessment s , using real and simulated patients , were carried out before the course , immediately after the supervision period and 3 months later . Interviews were rated objective ly using the Medical Interview Aural Rating Scale ( MIARS ) to assess nurses ' ability to use key skills , respond to patient cues and identify patient concerns . RESULTS Assessment s with simulated patients showed that the training programme was extremely effective in changing competence in all three key areas . However , only those who experienced supervision showed any evidence of transfer . Improvements were found in the supervised groups ' use of open questions , negotiation and psychological exploration . Whilst neither group facilitated more disclosure of cues or concerns , those in the experimental group responded more effectively to the cues disclosed , reduced their distancing behaviour and increasing their exploration of cues . CONCLUSIONS The study has shown that whilst training enhances skills , without intervention , it may have little effect on clinical practice . The potential role of clinical supervision as one way of enhancing the clinical effectiveness of communication skills training programmes has been demonstrated . PRACTISE IMPLICATION S : This study raises questions about the effectiveness of training programmes which do not incorporate a transfer element , and provides evidence to support the need for clinical supervision for clinical nurse specialist PURPOSE This study assessed the efficacy of a 38-hour communication skills training program design ed to train a multidisciplinary radiotherapy team . METHODS Four radiotherapy teams were r and omly assigned to a training program or a waiting list . Assessment s were scheduled at baseline and after training for the training group and at baseline and 4 months later for the waiting list group . Assessment s included an audio recording of a radiotherapy planning session to assess team members ' communication skills and expression of concerns of patients with breast cancer  ( analyzed with content analysis software ) and an adapted European Organisation for Research and Treatment of Cancer satisfaction with care question naire completed by patients at the end of radiotherapy . RESULTS Two hundred thirty-seven radiotherapy planning sessions were recorded . Compared with members of the untrained teams , members of the trained teams acquired , over time , more assessment skills ( P = .003 ) and more supportive skills ( P = .050 ) and provided more setting information ( P = .010 ) . Over time , patients interacting with members of the trained teams asked more open questions ( P = .022 ) , expressed more emotional words ( P = .025 ) , and exhibited a higher satisfaction level regarding nurses ' interventions ( P = .028 ) . CONCLUSION The 38-hour training program facilitated transfer of team member learned communication skills to the clinical practice and improved patients ' satisfaction with care PURPOSE Cancer Care Ontario has m and ated that all health care professionals working within oncology centres in Ontario should routinely screen and address symptoms of anxiety and depression in cancer patients . This study aims to assess the informational needs of  radiation therapists ( RTs ) concerning the discussion and management of anxiety and depression symptoms in patients receiving radiation therapy treatment . It will also attempt to determine whether RTs believe that review ing patients ' self-reported symptoms should be included as part of their routine patient assessment . METHODS A question naire was initially piloted at the host institution to six r and omly chosen RTs and then sent via e-mail to all radiation therapists practising in Ontario , Canada ( N = 921 ) . The online question naire consisted of multiple choice questions and was divided into the following four themes : ( 1 ) RT comfort levels surrounding the topics of anxiety and depression ; ( 2 ) management of anxiety and depression in cancer patients ; ( 3 ) further education needed/requested in anxiety and depression symptom management ; and ( 4 ) the Edmonton Symptom Assessment System ( ESAS ) . Data analyses included the calculation of means and two sample two-sided t tests to examine the relationships between various demographics and responses . RESULTS RTs feel more comfortable in the discussion of issues surrounding anxiety when compared with depression . The most common positive factor affecting RTs ' comfort levels addressing emotional distress is previous experience with patients who have expressed these symptoms ; whereas , the most common adverse factor affecting comfort levels is the lack of education regarding emotional distress . Eighty-seven percent of RTs would like further education surrounding anxiety and depression symptom management . Seventy-eight percent of RTs agree that ESAS is an important tool for symptom management ; however , only 16 % actually use this tool in their clinical practice . CONCLUSIONS Although RTs within Ontario feel fairly comfortable addressing anxiety and depression symptoms , they have indicated that further education regarding these topics would be useful . Further research into seamlessly incorporating ESAS into RTs ' daily practice should be considered PURPOSE Patients with cancer have a high prevalence of distress . We evaluated whether distress monitoring and needs assessment using the Distress Thermometer and Problem List ( DT&PL ) improved patient outcomes . PATIENTS AND METHODS We conducted an unblinded , two-arm , parallel r and omized controlled trial at two sites among patients starting radiotherapy or chemotherapy .  The intervention group completed the DT&PL , rating distress and discussing sources of distress with a trained radiographer/nurse . No specific triage algorithms were followed . The control group received usual care . The main outcome measure was psychological distress ( Profile of Mood States [ POMS ] , short form ) up to 12 months ; secondary outcomes were quality of life ( European Organisation for Research and Treatment of Cancer Quality of Life Question naire C30 ) and health care costs . RESULTS Of 220 patients r and omly assigned , 112 patients were allocated to the DT&PL . Ninety-five percent completed the primary outcome at 12 months . The DT&PL took 25 minutes ; one third of patients had high levels of distress , and most reported physical ( 84 % ) or emotional ( 56 % ) problems . There was no evidence of an effect of the DT&PL on adjusted POMS scores over follow-up ( difference between groups , -1.84 ; 95 % CI , -5.69 to 2.01 ; P = .35 ) or in secondary outcomes . The DT&PL cost £ 19 ( $ 28 ) per patient and did not lower subsequent health care costs . Few patients ( < 3 % ) in either arm of the trial were referred to a clinical psychologist . CONCLUSION Patients with cancer have a high prevalence of distress . Needs assessment can be performed quickly and inexpensively . However , the DT&PL was not cost effective in improving patient mood states . It is important to explore the reasons for this so that oncology units can design better services to support patients 
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Conclusions There are promising indications that CST can be successfully introduced to improve emotional conversations between RT members and patients .
With the right support , the RT can play an important role to help patients cope with their emotional concerns .