April 4-6, 2024 • Hyatt Regency • Lexington, KY
Innovations in Health Communication
Innovations in Health Communication
Abstract: Clinician-Patient Communication About Cancer Treatment Misinformation: The Misinformation Response Model
Objective: 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 [1]. 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.
Methods: We utilized a qualitative observational design during the standardized role-play formulation. Using a convenience sampling strategy, we recruited cancer clinicians at the University of Florida, Duke University, and the Huntsman Cancer Institute via email. Contacted clinicians consisted of medical or radiation physicians, physician’s assistants, and nurse practitioners; they included Hematology-Oncology fellows and senior radiation oncology residents (PGY 3-5). Interested clinicians contacted the study coordinator, who scheduled their role play, which was conducted over Zoom for feasibility. 17 cancer clinicians participated in one-on-one audio-recorded standardized patient (SP) encounters, in which a breast cancer SP asked three questions based on CTM. Once the role play concluded, the SP was excused while the study coordinator collected demographics and information for their $50 e-gift card distribution. Lastly, the clinician responded to a 4-question survey, which gauged their comfort level and experience engaging in communication about CTM with patients, as well as their comfort during the role play and perceived authenticity of the SP. We thematically analyzed transcriptions of the recordings using deductive and inductive analysis.
Results: During their communication with the SP, clinicians used all four responses previously identified to address CTM in a clinical setting. Furthermore, the strategies they utilized during each response were validated. This observational approach allowed us to refine strategies within each response and identify communication skills clinicians enact to address CTM: To 1) work to understand the misinformation, clinicians were open about their own knowledge, proposed to educate themselves further by conducting research, and took the information seriously. To 2) correct the misinformation through education, clinicians stated the information is incorrect, explained why the information is incorrect, emphasized the importance of a scientific base for the quality of information, and refocused on the patient’s specific situation. To 3) advise about future online searches, clinicians suggested sites or recommended resources, and educated the patient on the type of scientific evidence to look for online. To 4) preserve the clinician-patient relationship, they cultivated openness, enacted support, and empowered the patient.
Conclusion: Building on our previous research on responses and strategies, these findings provide a strong foundation for the Misinformation Response Model for cancer clinicians by identifying conceptual and concrete applications. As this is the first study observing clinicians’ communication with patients explicitly about CTM, future research should examine which components of the model are most effective in improving patient outcomes.
Methods: We utilized a qualitative observational design during the standardized role-play formulation. Using a convenience sampling strategy, we recruited cancer clinicians at the University of Florida, Duke University, and the Huntsman Cancer Institute via email. Contacted clinicians consisted of medical or radiation physicians, physician’s assistants, and nurse practitioners; they included Hematology-Oncology fellows and senior radiation oncology residents (PGY 3-5). Interested clinicians contacted the study coordinator, who scheduled their role play, which was conducted over Zoom for feasibility. 17 cancer clinicians participated in one-on-one audio-recorded standardized patient (SP) encounters, in which a breast cancer SP asked three questions based on CTM. Once the role play concluded, the SP was excused while the study coordinator collected demographics and information for their $50 e-gift card distribution. Lastly, the clinician responded to a 4-question survey, which gauged their comfort level and experience engaging in communication about CTM with patients, as well as their comfort during the role play and perceived authenticity of the SP. We thematically analyzed transcriptions of the recordings using deductive and inductive analysis.
Results: During their communication with the SP, clinicians used all four responses previously identified to address CTM in a clinical setting. Furthermore, the strategies they utilized during each response were validated. This observational approach allowed us to refine strategies within each response and identify communication skills clinicians enact to address CTM: To 1) work to understand the misinformation, clinicians were open about their own knowledge, proposed to educate themselves further by conducting research, and took the information seriously. To 2) correct the misinformation through education, clinicians stated the information is incorrect, explained why the information is incorrect, emphasized the importance of a scientific base for the quality of information, and refocused on the patient’s specific situation. To 3) advise about future online searches, clinicians suggested sites or recommended resources, and educated the patient on the type of scientific evidence to look for online. To 4) preserve the clinician-patient relationship, they cultivated openness, enacted support, and empowered the patient.
Conclusion: Building on our previous research on responses and strategies, these findings provide a strong foundation for the Misinformation Response Model for cancer clinicians by identifying conceptual and concrete applications. As this is the first study observing clinicians’ communication with patients explicitly about CTM, future research should examine which components of the model are most effective in improving patient outcomes.