Abstract
Oxford Textbook of Communication in Oncology and Palliative Care, edited by David W. Kissane, Barry D. Bultz, Phyllis N. Butow, Carma L. Bylund, Simon Noble, and Susie Wilkinson, takes on the challenge of teaching communication skills through a textbook. This text meets the challenge head on and surpasses expectations. It is a useful resource for anyone involved in communication training.
Communication training can be difficult, in part, because some attributes of a good communicator, such as charisma, empathy, timing, and nonverbal skills, come more naturally to some individuals. However, no matter a clinician's skills at baseline, they can be improved. Communication in the world of oncology is particularly difficult, due to the gravitas of the situations and the complexity of the medicine involved. There is a high expectation placed on oncology teams to communicate well, as patients tend to prefer having difficult conversations with their primary oncology teams. Training oncology fellows to communicate well is challenging, as the sheer volume of medical information in the fellowship leaves little time or energy for communication skills training.
As a part of my training, I was fortunate enough to attend, and subsequently teach, in a yearlong live communication curriculum. I have also read numerous texts and gone through other curricula related to communication training. I now reside on the other side of the desk, as an attending, teaching communication skills to fellows and residents of diverse levels of training and specialties, and I fully believe in the utility of an oncology-focused communication curriculum. There are specific communication skills my palliative fellows need to get during their rotations with me, and I am always working to improve this aspect of their education. Unless a learner comes from an internal medicine background at an academic center, the topics of communication will be completely foreign. This text helps to close the gap.
For some institutions, having a continuous in-person communication course is unfeasible. In this very common situation, the way we teach communication skills has to be adjusted to be most beneficial for learners. These situations rely more on didactic sessions, and for this common scenario, this text is an invaluable resource. The oncology-specific chapters provide insight that other communication resources do not possess. The types of conversations I have now differ from those in my training. I felt very comfortable teaching communication in the community hospital setting. This text has increased my confidence in teaching in a purely oncology setting.
The text is well written, and covers a wide variety of useful topics. For example, this text offers an excellent chapter on the utility of recording appointments. I do feel there are areas in which this text could be improved. Inadequate patient comprehension is an area where providers of all specialties and levels fall short. Good communicators check in with patients and families regarding their understanding of the clinical situation. A provider could be the best communicator, taking advantage of all the skills in this text, but if a patient or family has poor understanding of the clinical situation, it is all for naught. In addition, a topic that could be helpful in future editions is a chapter that aids providers to craft simple ways to describe to a lay person topics such as chemotherapy, immunotherapy, radiation, palliative care, hospice, and pain management. I spend education time with my fellows on this topic and patients respond very well.
Initially, I had concerns regarding the ability of the textbook medium to aid in communication training. Since receiving a copy of this text for review, it has become a valuable resource in my teaching communication to oncology and palliative medicine fellows at an NCCN Member Institute. I would recommend it for all trainees in the oncology setting, as well as any teaching attending clinicians.