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Background Communicating with oncology patients about ceilings of treatment (COT), Do Not Attempt Cardiopulmonary Resuscitation (DNACPR), prognosis, advance care planning (ACP) and stopping systemic anti-cancer treatment (SACT) is emotionally challenging.1 2 Randomised controlled trials show that training courses significantly improve communication skills for oncologists.3–5 This quality improvement project explored whether an advanced communication course could support oncologists in conducting complex conversations (CCC) in our tertiary oncology hospital. Methods Following a Plan Do Study Act cycle, we reviewed existing audit data relating to end-of-life care conversations (Plan). We sent surveys to oncology registrars and consultants exploring their experiences of CCC (Do). Responses were reviewed for themes (Study) and presented to the hospital palliative care team (PCT) and the oncology teams to explore co-creating a bespoke intervention (Act). Results 45%(10/22 responses) of oncology registrars and 83%(10/12 responses) of consultants had conversations relating to COT, DNACPR, prognosis, ACP and stopping SACT at least once a week. The majority found all 5 topics to be 'somewhat challenging' (from 'least' to 'very challenging'). Both groups trended towards feeling 'apprehensive' in the lead up to CCC and 'thinking about conversations once at home'. In a Likert scale (1=not had enough CCC training, 10=had sufficient CCC training), oncology registrars scored 5.6(mean) vs. consultants 8.3(mean). 50% of consultants and 77% of registrars wanted more training, ideally by attending courses, simulation and shadowing the PCT. They wanted a high-yield course of short duration during protected time as they had difficulties obtaining study leave. Conclusions Any advanced communication course must be learner-led, resource-sensitive, sustainable and address the emotional aspects of challenging consultations. Increased joint working between the PCT and oncology teams will yield mutual learning. However, communication skills training needs to be formally recognised as mandatory in the oncology curriculum for lasting progress to be made. References Fallowfield L, Jenkins V. Communicating sad, bad, and difficult news in medicine Internet. 2004. Available from: http://www.edhep.co.uk/our.htm. Dean A, Willis, Susan. The use of protocol in breaking bad news: evidence and ethos Internet. 2016. Available from: http://shura.shu.ac.uk/12857/. Fallowfield L, Jenkins VA, Saul J. Efficacy of a Cancer Research UK communication skills training model for oncologists: a randomised controlled trial Internet. 2016. Available from: https://www.researchgate.net/publication/292000868. Kissane DW, Bylund CL, Banerjee SC, Bialer PA, Levin TT, Maloney EK, et al. Communication skills training for oncology professionals. Journal of Clinical Oncology. 2012;39:1242–7. Barth J, Lannen P. Efficacy of communication skills training courses in oncology: a systematic review and meta-analysis. Annals of Oncology. Oxford University Press; 2011;22:1030–40.
Tran et al. (Fri,) studied this question.