Predictors of physicians' communication performance in a decision-making encounter with a simulated advanced-stage cancer patient: A longitudinal study

Abstract

Objectives: Physicians' characteristics that influence their communication performance (CP) in decision-making encounters have been rarely studied. In this longitudinal study, predictors of physicians' CP were investigated with a simulated advanced-stage cancer patient.

Methods: Physicians (n=85) performed a decision-making encounter with a simulated patient (SP). Their CP was calculated by analyzing encounter transcripts with validated interaction analysis systems. Potential specific psychological predictors were physicians' empathy towards the SP (Jefferson Scale of Physician Empathy, JSPE) and their decisional conflict about the treatment (Decisional Conflict Scale, DCS). Potential general psychological predictors were physicians' empathy towards cancer patients (JSPE), their decisional conflict about cancer patients' treatments (DCS), and their affective reactions to uncertainty (Physicians' Reactions to Uncertainty, PRU).

Results: Physicians' CP was predicted by their decisional conflict about the SP's treatment (DCS) (β=0.41; p< 0.001) and their affective reactions to uncertainty regarding cancer treatments (PRU) (β=-0.31; p=0.003).

Conclusion: During encounters with advanced-stage cancer patients, physicians' awareness of uncertainty about which treatments to consider may facilitate their communication performance, whereas physicians' affective reactions to uncertainty may inhibit their performance.

Practice implications: Physicians' decisional conflict and reactions to uncertainty should be addressed in communication skills training programs.

Keywords: Cancer; Communication; Decision-making; Physicians; Psychological predictors; Simulated patient.