Testing the ABCs of Serious Illness Program for Oncology Trainees: A Feasibility Trial Comparing Different Learning Formats for a Virtual Communication Curriculum.

Abstract

Background: ABCs (All providers, Better Communication skills) of serious illness communication is a novel curriculum that could enhance postgraduate oncology training. The program combines electronic learning modules (ELMs), standardized patient (SP) encounters, and coaching, all in a virtual format. We assessed feasibility of a randomized controlled trial (RCT) comparing different training experiences.

Methods: We conducted a pilot for a RCT at three academic centers. Postgraduate oncology trainees were randomized to complete ELMs and SP encounters with coaching (intervention arm) versus ELMs only (control arm). Feasibility measures comprised the primary analysis. Secondary analyses explored the impact of different training experiences. Outcomes were measured through pre- and post-intervention simulation-based assessments (COM-ON rating scale), and surveys rating self-efficacy (End-of-Life Professional Caregiver Survey [EPCS] score) and satisfaction.

Results: Twenty-three learners participated (37% recruitment). Adherence was 100% and data collection was near complete. All feasibility metrics were met except for the recruitment target of 75%. Self-efficacy ratings improved from baseline (EPCS score increased significantly (p < 0.001), mean paired difference = 0.73 (standard deviation [SD] = 0.78) [95% confidence interval (CI), 0.37-1.08]), as did quality of communication in simulations (COM-ON score increased significantly (p < 0.001), mean paired difference = 0.59 (SD = 0.73) [95% CI, 0.28-0.91]). Improvement was greatest in the intervention arm for both. Participants reported high satisfaction with virtual learning.

Conclusions: Recruitment was below target, but study activities were feasible in virtual format. The curriculum improved communication skills. The addition of virtual SPs and coaching optimized learning. The curriculum was associated with improved self-efficacy rating for serious illness communication with oncology patients. Lessons learned will support further medical education research in this area.