New training course could boost clinical trial recruitment

Tailor-made training courses in communication for doctors and nurses could help increase the number of patients joining clinical trials, Cancer Research UK scientists announced at UICC’s¹ Fourth World Conference for Cancer Organisations, in Dublin.

According to research, over half of all doctors and a quarter of specialist cancer nurses say that providing clear and easy to understand information on trials and obtaining consent are among their biggest communication problems. Lack of confidence and time means that healthcare professionals may be less likely to discuss clinical trials with their patients.

To tackle the problem, Cancer Research UK scientists have developed a communication course for doctors and nurses which will help them discuss treatment and improve patient enrolment to clinical trials.

Over one hundred doctors and nurses were asked to rate their confidence when approaching different types of patients about possible cancer treatment trials. The doctors and nurses were filmed discussing trials with professional actors skilled in patient role play. These sessions were then rated by the actors and people trained in rating these discussions. After completing the specially designed communication course, all the assessments were made again. The researchers could then compare the skills of the doctors and nurses before and after the course.

The training course is made up of four video-taped modules together with a series of interactive exercises, presentations and discussion sessions. Health professionals are trained on the specific aspects of clinical trials that patients have difficulty understanding, including randomisation, standard treatment versus new treatment, side effects and the importance of clinical trials.

The course also covers the difficulties in communicating with patients and family members with particular problems. These issues can include demands for untested treatment, relatives insisting on treatment not wanted by the patients and dealing with patients who bring along newspaper cuttings or internet information to present to the staff.

After the course the doctors and nurses felt more confident about trial discussions and their communication skills were also rated as being improved. The actors reported a significant improvement in the quality of information they were given and in their understanding of the trial options available. Researchers believe that with this greater understanding there will be an increase in the number of patients entering clinical trials.

Professor Lesley Fallowfield, Cancer Research UK’s Director of Oncology and co-author of the study, says: “Every new cancer treatment must be tested with patients in a clinical trial. If not enough patients enrol on trials, the pace of research slows. This study shows us that giving bespoke training to doctors and nurses increases confidence and competence. The knock on effect should then be that more patients enrol in trials.

She adds: “We developed this training programme specifically to benefit doctors and nurses, their patients and their research. The next step is to roll it out across the UK. Two days spent doing this course should make a real difference and speed the progress of new research.”

Dr Valerie Jenkins, based at Cancer Research UK’s Psychosocial Oncology Group at the University of Sussex and who is presenting the study in Dublin says: “With Cancer Research UK funding, we are about to make some new modules for this training programme that look at overcoming the problems for patients and families invited to join paediatric and teenage cancer trials. Our aim is to help develop skills to target any age group and deal with any issues about entering clinical trials.”

Kate Law, Head of Clinical Trials at Cancer Research UK says: “Providing training to doctors and nurses to improve their skills and knowledge should help deliver the best possible cancer treatment. Development of new drugs and better treatments rely on clinical trials. This kind of communication course can help all those at the coal face of cancer research and the end result is that all patients will get better treatment quicker.”

ENDS