Impact of a Goal of Care Communication Training Program for Oncology Clinical Staff

Authors

Gary Martinez, The University of Texas MD Anderson Cancer CenterFollow

Abstract

Abstract

Goals of care (GoC) refers to medical care decisions made by patients and families that are consistent with their personal values and preference choices. However, the oncology healthcare system does not always align with the patient’s GoC values and preferences. Clinical experts suggest formalized GoC education to improve this practice gap.Accordingly, MD Anderson Cancer Center implemented GoC training for front-line clinical staff using the evidence-based COMFORT Model to enhance the participants’ ability to have connected GoC conversations and enhance their comfort levels in responding to patients’ emotions. Our institution’s GoC education team compared the pretest and posttest survey responses of 1415 front-line practicing nurses, social workers, and chaplains participating in GoC training. This training program included 4 or 8 hours of online asynchronous training and a 3-hour live engagement session. A COMFORT Feedback Survey recorded the participants’ perceived ability to have connected conversations and comfort responding to patients’ emotions using a 5-point Likert-type scale (1 = very low, 2 = low, 3 = average, 4 = high, 5 = very high). Researchers used Qualtrics software to collect and score participant survey responses. The data were analyzed using Intellectus Statistics software to describe participant characteristics, calculate scaled survey variables of ability and comfort, and measure statistically significant differences (t-testing) between the pre- and posttest scores. The most frequently reported demographic features were age 40-49 years (27.63%), female gender (80.42%), Asian or Asian American ethnicity (61.13%), and inpatient area of practice (64.52%). The most frequently reported ability level was average (n = 562, 39.72%) before training and high (n = 709, 50.11%) after training. Likewise, the most frequently reported comfort level was average (n = 528, 37.31%) before training and high (n = 717, 50.67%) after training. The 2-tailed paired-samples t-test showed the differences for both variables to be statistically significant (P < .001), underscoring the impact of the training program. These findings indicate that evidence-based GoC educational training equips oncology front-line clinical staff with the self-efficacy skills for effective GoC communication. However, more investigation is needed to understand how these findings affect practice application and implementation and institutional outcomes.

DOI

https://doi.org/10.52519/ACEQI.25.1.1.a16

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-Share Alike 4.0 International License.

Recommended Citation

Martinez G. Impact of a Goal of Care Communication Training Program for Oncology Clinical Staff. Advances in Cancer Education and Quality Improvement. 2025; 1(1). doi: https://doi.org/10.52519/ACEQI.25.1.1.a16.