***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 Informed consent is required for both st and ard cancer treatments and experimental cancer treatments in a clinical trial . Effective and sensitive physician-patient communication about informed consent is difficult to achieve . Our aim was to train doctors in clear , collaborative and ethical communication about informed consent and evaluate the impact of training on doctor behaviour , stress and satisfaction . PARTICIPANTS AND METHODS Participants were 21 oncologists from 10 Australian/New Zeal and ( ANZ ) centres and 41 oncologists from 10 Swiss/German/Austrian ( SGA ) centres . Oncologists were r and omized to participate in a 1-day workshop or not .  Patients were recruited before and after the training . Doctors were asked to su bmi t 1 - 2 audiotaped consultations before and after training . Doctors completed outcome measures before and after completing the post-training cohort recruitment . RESULTS Ninety-five consultation interactions were audiotaped . Doctors strongly endorsed the training . ANZ intervention doctors demonstrated a significant increase in collaborative communication ( P = 0.03 ) . There was no effect of training on other doctor behaviours .  Trained doctors did not demonstrate reduced stress and burnout . Patient outcomes are presented elsewhere . CONCLUSIONS Training can improve some aspects of the process of obtaining informed consent . Methods to increase the impact of training are required and may include longer training and more intensive follow-up OBJECTIVE The underlying mechanisms modifying clinician 's communication skills by means of communication skills training ( CST ) remain unknown . Defense mechanisms , defined as psychological processes protecting the individual against emotional stress , may be a mediating factor of skills improvement . METHODS Using an adapted version of the Defense Mechanism Rating Scale-Clinician , this study evaluated clinicians ' defense mechanisms and their possible modification after CST . Interviews with simulated patients of oncology clinicians ( N=57 ) participating in CST ( pre-/post-CST with a 6-month interval ) were compared WITH interviews with the same simulated patients of oncology clinicians ( N=56 ) who did not undergo training ( T1 and T2 with a 6-month interval ) . RESULTS Results showed ( i ) a high number ( mean=16 , SD=6 ) and variety of defenses triggered by the 15-min interviews , ( ii ) no evolution difference between groups , and ( iii ) an increase in mature defenses after CST for clinicians with an initial higher level of defensive functioning . CONCLUSIONS This is the first study describing clinicians ' defensive functioning ; results indicate a possible mediating role of defenses in clinician-patient communication PURPOSE The aim of the study was to demonstrate that COM-ON-p , concise and individualized communication skills training ( CST ) , improves oncologists ' communication skills in consultations focusing on the transition to palliative care . METHODS Forty-one physicians were r and omly assigned to a control ( CG ) or intervention group ( IG ) . At t(0 ) , all physicians held two video-recorded consultations with actor-patient pairs . Afterward , physicians in the IG participated in COM-ON-p . Five weeks after t(0 ) , a second assessment took place ( t(1 ) ) . COM-ON-p consists of an 11-hour workshop ( 1.5 days ) , pre- and post assessment ( 2 hours ) , and coaching ( 0.5 hours ) . Physicians focused on practicing individual learning goals with actor patients in small groups . To evaluate the training , blinded raters assessed communication behavior of the physicians in video-recorded actor-patient consultations using a specific checklist . Data were analyzed using a mixed model with baseline levels as covariates . RESULTS Participants in the IG improved significantly more than those in the CG in all three sections of the COM-ON-Checklist : skills specific to the transition to palliative care , global communication skills , and involvement of significant others ( all P < .01 ) . Differences between the CG and IG on the global items of communication skills and involvement of significant others were also significant ( P < .01 ) . Effect sizes were medium to large , with a 0.5-point improvement on average on a five-point rating scale . CONCLUSION Physicians can be trained to meet better core challenges during the transition to palliative care through developed concise CST . Generalization and transfer into clinical practice must be proven in additional studies Background : Communication skills training has proven to be an effective means to enhance communication of health care professionals in oncology . These effects are well studied in st and ardized setting s. The question of transferring these skills into clinical consultations remains open . We build up on a previous developed training concept consisting of a workshop and coaching . This training achieved a medium effect size in two studies with st and ardized patients . In the current study , we exp and ed and manualized the coaching concept , and we will evaluate effects of a varied number of coaching sessions on real clinical consultations . Our aim is to determine how much coaching oncologists need to transfer communication skills into clinical practice . Methods / design : Physicians of two German medical centers will participate in a workshop for communication skills and will be r and omized to either a group with one coaching session or a group with four coaching sessions following the workshop . The participation is voluntary and the physicians will receive medical education points . Consultations held by the participating physicians with actual patients who gave their informed consent will be filmed at three time points . These consultations will be evaluated by blinded raters using a checklist based on the training content ( primary outcome ) . Secondary outcomes will be the self-evaluated communication competence by physicians and an evaluation of the consultations by both physicians and patients . Discussion : We will evaluate our communication training concept on three levels – rater , physician and patient – and concentrate on the transfer of communication skills into real life situations . As we emphasize the external validity in this study design , limitations will be expected due to heterogeneity of data . With this study we aim to gain data on how to improve communication skills training that will result in better patient outcomes . Trial registration : German Clinical Trials Register DRKS00004385 BACKGROUND The International Breast Cancer Study Group conducted a phase III trial in Australian/New Zeal and ( ANZ ) and Swiss/German/Austrian ( SGA ) centres on training doctors in clear and ethical information delivery about treatment options and strategies to encourage shared decision making . METHODS Medical , surgical , gynaecological and radiation oncologists , and their patients for whom adjuvant breast cancer therapy was indicated , were eligible . Doctors were r and omised to participate in a workshop with st and ardised teaching material and role playing . Patients were recruited in the experimental and control groups before and after the workshop . RESULTS In ANZ centres , 21 eligible doctors recruited a total of 304 assessable patients . In SGA centres , 41 doctors recruited 390 patients . The training was well accepted . There was no overall effect on patient decisional conflict ( primary endpoint ) 2 weeks after the consultation . Overall , patients were satisfied with their treatment decision , their consultation and their doctors ' consultation skills . Considerable variation was observed in patient outcomes between SGA and ANZ centres ; the effect sizes of the intervention were marginal ( < 0.2 ) . CONCLUSIONS Shared decision making remains a challenge . A sustained training effect may require more intensive training tailored to the local setting . Cross-cultural differences need attention in conducting trials on communication interventions A r and omized pre- and post-test control group design was conducted in 12 oncology wards to investigate the effectiveness of an intervention , existing of a communication skills training with web-enabled video feedback and a Question Prompt Sheet ( QPS ) , which aim ed to improve patient education to older cancer patients ( ≥65 years ) . The effects were studied by analyzing question naires and video recordings of patient education sessions preceding chemotherapy with 210 different patients .  Patients ' recall of information was the primary outcome of the study . Recall was checked against the actual communication in the video-recordings . Moreover , communication skills were assessed by observing the extent to which nurses implemented 67 communication aspects , categorized in seven dimensions , using the QUOTE(chemo ) . Experimental nurses demonstrated a significant intervention effect on communicating realistic expectations . Within-group improvements were measured in the experimental group for tailored communication , affective communication and interpersonal communication . Although the use of a QPS significantly increased question asking , only limited results were found on older patients ' recall scores . The overall proportion recall of recommendations showed a marginally significant pre-/post-change in proportion recall in favour of the experimental group and there was a significant pre-/post-change in two out of six sub-categories . The results indicate that  nurses ' communication skills can be improved by communication skills training . More research is needed to underst and the difficult relationship between patient-provider communication and recall of information ABSTRACT BACKGROUND Physician recommendation of colorectal cancer ( CRC ) screening is a critical facilitator of screening completion . Providing patients a choice of screening options may increase CRC screening completion , particularly among racial and ethnic minorities . OBJECTIVE Our purpose was to assess the effectiveness of physician-only and physician – patient interventions on increasing rates of  CRC screening discussion s as compared to usual care . DESIGN This study was quasi-experimental . Clinics were allocated to intervention or usual care ; patients in intervention clinics were r and omized to receipt of patient intervention . PARTICIPANTS Patients aged 50 to 75 years , due for CRC screening , receiving care at either a federally qualified health care center or an academic health center participated in the study .INTERVENTIONIntervention physicians received continuous quality improvement and communication skills training . Intervention patients watched an educational video immediately before their appointment . MAIN MEASURES Rates of patient-reported 1 ) CRC screening discussion s , and 2 ) discussion s of more than one screening test . KEY RESULTS The  physician – patient intervention ( n = 167 ) result ed in higher rates of CRC screening discussion s compared to both physician-only intervention ( n = 183 ; 61.1 % vs.50.3 % , p = 0.008 ) and usual care ( n = 153 ; 61.1 % vs. 34.0 % p = 0.03 ) . More discussion s of specific CRC screening tests and discussion s of more than one test occurred in the intervention arms than in usual care ( 44.6 % vs. 22.9 % , p = 0.03 ) and ( 5.1 % vs. 2.0 % , p = 0.036 ) , respectively , but discussion of more than one test was uncommon . Across all arms , 143 patients ( 28.4 % ) reported discussion of colonoscopy only ; 21 ( 4.2 % ) reported discussion of both colonoscopy and stool tests . CONCLUSIONS Compared to usual care and a physician-only intervention , a physician – patient intervention increased rates of CRC screening discussion s , yet discussion s overwhelmingly focused solely on colonoscopy . In underserved patient population s where access to colonoscopy may be limited , interventions encouraging discussion s of both stool tests and colonoscopy may be needed INTRODUCTION The importance of effective communication skills to sustain the cancer patient  quality of life ( QOL ) and their satisfaction with healthcare professionals is well documented . This study aims to assess the effectiveness of communication skills training ( CST ) of nurses for patient QOL and their satisfaction with healthcare professionals just after being diagnosed with cancer . METHODS This is a secondary analysis of a r and omized controlled trial . Eight nurses , who mainly provide psychological and informational support for patients soon after they were informed of their cancer diagnosis by physicians at a cancer screening center , were r and omly assigned to an experimental group attending a CST program ( four nurses ) or to a control group ( four nurses ) . Eighty-nine patients with gastric , colorectal , or breast cancer were supported and assessed by either group of nurses during the study period . The effectiveness for patient QOL and their satisfaction with healthcare professionals was assessed by administering the Short Form-8 Health Survey ( SF-8 ) and a single-item VAS three times ( 1 week after diagnosis : T1 ; 1 month after diagnosis : T2 ; and 3 months after diagnosis : T3 ) . RESULTS Repeated measures analysis of variance showed a group-by-time significant increase of the mental aspects of SF-8 ( F=3.48 ; P=0.03 ) and 
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Some recommendations , especially those regarding content and pedagogic tools , were followed by most providers , while others , such as setting , objectives and participants , were not .
While medicine , especially clinical communication , is socially and culturally embedded , some recommendations regarding CST programmes seem to be universally valuable , contributing to ensure quality and enhanced credibility , and thus endorsement and sustained implementation , of CST programmes in the oncology setting