Advanced communication: A critical component of high quality gynecologic cancer care: A Society of Gynecologic Oncology evidence based review and guide

• Published in: Gynecologic oncology 2019-10, Vol.155 (1), p.161-169
• Main Authors: Littell, Ramey D., Kumar, Amanika, Einstein, M. Heather, Karam, Amer, Bevis, Kerri
• Format: Article
• Language: English
• Subjects: Advanced communication; Communication skills; Delivering bad news; Empathy; Goals of care; Palliative care; Serious illness
• ISSN: 0090-8258; 1095-6859
• DOI: 10.1016/j.ygyno.2019.07.026

Effective communication between gynecologic oncology providers and patients is vital to patient-centered care. Skilled communication improves the patient's knowledge retention, builds trust in providers, enhances shared decision-making, and alleviates anxiety of both patients and caregivers. Effective communication is also associated with reduced provider burnout due to improved comfort from possessing the skills to handle emotionally charged situations. Therefore, training in serious illness communication skills is critically important to gynecologic oncology practice and benefits patients, providers, and the healthcare system. Like surgical skills, communication skills can be learned and improved upon, particularly by making use of communication skills courses and other resources. While the purpose of each conversation will vary based on the medical setting, most communication roadmaps incorporate four basic components: 1) Assess patient knowledge and understanding, 2) inform patient in accordance with her communication preferences, 3) recognize and respond to emotion 4) elicit patient values, and create a plan that aligns with those values. Improved patient outcomes associated with addressing patient emotions underscore a critical need to recognize and address emotional cues during difficult conversations. We present strategies for delivering serious news, and for discussing prognosis and goals of care. In each strategy, we highlight skills for recognizing and responding to patient and family emotional cues. •Barriers to serious conversations can be overcome by using evidence-based skills and structured conversation maps.•Skillfully addressing patient emotions improves knowledge retention, satisfaction, trust in providers, and reduces anxiety.•Strategies and skills proven to improve provider/patient communication are demonstrated using vignettes.