Mullis M Devyn, Fisher Carla L, Johnson Skyler B, Liu Tianshi, Amin Tithi B, Rogers Sherise, DeGruccio Kennan, Bylund Carma L
Department of Health Outcomes & Biomedical Informatics, College of Medicine, University of Florida, 2004 Mowry Road, Gainesville, FL 32610, United States of America.
Department of Radiation Oncology, School of Medicine, University of Utah, 30 N 19000 E, Salt Lake City, UT 84132, United States of America.
PEC Innov. 2024 Jul 6;5:100319. doi: 10.1016/j.pecinn.2024.100319. eCollection 2024 Dec 15.
Cancer treatment misinformation (CTM) is pervasive and impacts patient health outcomes. Cancer clinicians play an essential role in addressing CTM. We previously identified four self-reported responses that characterize the communication process clinicians engage in to address CTM. Clinicians 1) work to understand the misinformation; 2) correct the misinformation through education; 3) advise about future online searches; and 4) preserve the clinician-patient relationship. We sought to confirm and expand on the model we developed by observing cancer clinicians' communication while addressing CTM with a standardized patient (SP).
17 cancer clinicians were audio recorded in a SP encounter, in which a breast cancer SP asked three questions based on CTM. We thematically analyzed transcriptions of the recordings.
Clinicians used four responses with associated strategies and skills to address CTM in a standardized clinical encounter, confirming the previously developed model. The four responses were: (1) work to understand the misinformation; (2) correct the misinformation through education; (3) advise about future online searches; and (4) preserve the clinician-patient relationship. This observational approach allowed us to refine strategies within each response and identify communication skills clinicians enact to address CTM.
These findings provide a strong foundation for the Misinformation Response Model for cancer clinicians. Future research should examine which components of the model are most effective in improving patient outcomes.
This is the first study observing clinicians' communication through simulated practice with SPs about CTM.
癌症治疗错误信息（CTM）普遍存在并影响患者的健康结局。癌症临床医生在应对CTM方面发挥着至关重要的作用。我们之前确定了四种自我报告的反应，这些反应描述了临床医生在应对CTM时所参与的沟通流程。临床医生：1）努力理解错误信息；2）通过教育纠正错误信息；3）就未来的在线搜索提供建议；4）维护医患关系。我们试图通过观察癌症临床医生与标准化患者（SP）交流应对CTM时的沟通情况，来确认并扩展我们所建立的模型。
17名癌症临床医生在与一名SP的交流过程中被录音，在该过程中，一名乳腺癌SP基于CTM提出了三个问题。我们对录音的文字记录进行了主题分析。
临床医生在标准化临床交流中使用了四种反应及相关策略和技巧来应对CTM，证实了之前建立的模型。这四种反应分别是：（1）努力理解错误信息；（2）通过教育纠正错误信息；（3）就未来的在线搜索提供建议；（4）维护医患关系。这种观察方法使我们能够完善每种反应中的策略，并确定临床医生为应对CTM所采用的沟通技巧。
这些发现为癌症临床医生的错误信息应对模型提供了坚实的基础。未来的研究应考察该模型的哪些组成部分在改善患者结局方面最有效。
这是第一项通过与SP进行模拟实践观察临床医生关于CTM沟通情况的研究。
