Intended for healthcare professionals

Learning In Practice

Discussing randomised clinical trials of cancer therapy: evaluation of a Cancer Research UK training programme

BMJ 2005; 330 doi: (Published 17 February 2005) Cite this as: BMJ 2005;330:400
  1. V Jenkins (val{at}, senior research fellow in psycho-oncology1,
  2. L Fallowfield, professor in psycho-oncology1,
  3. I Solis-Trapala, statistical researcher2,
  4. C Langridge, data manager1,
  5. V Farewell, senior scientist3
  1. 1 Sussex Psychosocial Oncology Group, Brighton & Sussex Medical School, University of Sussex, Brighton BN1 9QG
  2. 2 Centro de Investigacion en Matematicas, Guanajuato, Mexico
  3. 3 MRC Biostatistics Unit, Institute of Public Health, Cambridge
  1. Correspondence to: V Jenkins
  • Accepted 10 January 2005


Objective To evaluate a training intervention aimed at improving healthcare professionals' communication with cancer patients about randomised clinical trials.

Design Before and after evaluation of training programme.

Setting Members of the National Cancer Research Network, Scottish Trials Network, and the Welsh Cancer Trials Network

Participants 101 healthcare professionals (33 clinicians and 68 research nurses).

Intervention Four modules delivered by a trained facilitator using videotapes and interactive exercises to cover general issues about discussing randomised clinical trials with patients, problems specific to adjuvant trials, trials with palliation as the goal, and trials where patients had a strong preference for one treatment arm.

Main outcome measures Before and after the intervention, participants were videotaped discussing a trial with an actor portraying a patient. These consultations were assessed for presence of information required by good clinical practice guidelines. The actor patients gave an assessment after each interview. Participants reported their self confidence about key aspects of trial discussion.

Results Analysis of the videotaped consultations showed that, after intervention, significantly more participants displayed key communication behaviours such as explaining randomisation (69 v 81, odds ratio 2.33, P = 0.033), checking patients' understanding (11 v 31, odds ratio 3.22, P = 0.002), and discussing standard treatment (73 v 88, odds ratio 4.75, P = 0.005) and side effects (69 v 85, odds ratio 3.29, P = 0.006). Participants' self confidence increased significantly (P < 0.001) across all areas. Actor patients' ratings of participants' communication showed significant improvements for 12/15 key items.

Conclusion This intensive 8 hour intervention significantly improved participants' confidence and competence when communicating about randomised clinical trials.


  • Contributors VJ and LF designed the educational training package. VJ, LF, and VF designed the evaluation project. CL was the data manager for the project. IS-T and VF conducted the statistical analysis. All authors contributed to writing the article. VJ is guarantor for the study.

  • Funding Cancer Research UK funded the project, and AstraZeneca provided an unrestricted educational grant to help video production.

  • Competing interests None declared.

  • Ethical approval None required.

  • Accepted 10 January 2005
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