The majority (95%) of lung cancer patients report experiencing lung cancer stigma from their family,
friends, and medical providers, with 48% specifically reporting experiencing stigma from their medical
providers. Stigma has negative effects on patients’ psychological well-being as well as their medical outcomes.
Stigma may be exacerbated within the context of clinical consultations in which physicians routinely probe
about patients’ smoking history and current smoking status. Empathic communication during these clinical
encounters may reduce perceived stigma and improve other patient outcomes. The goals of this study are to:
1) To adapt a communication skills training module focusing on empathic physician communication; 2)
examine the feasibility and acceptability of the empathic physician communication skills training intervention for
thoracic oncologists; and 3) pilot test the effect of the adapted empathic physician communication skills training
intervention on patient-reported stigma (primary), physician empathy, satisfaction with communication,
psychological distress, and chart audit of patient acceptance of referral to psychosocial and/or tobacco
cessation support services. To meet these goals, we will adapt an existing empathic physician communication
skills training module developed by MSK’s Communication Skills Training and Research Lab to meet the
specific smoking and stigma-related communication issues experienced by physicians treating patients with
lung cancer. Next, we will determine thoracic oncology physicians’ (n=30) rate of completion of the training,
training module evaluation as well as pre- and post-changes in empathic communication skill uptake with
video-recorded and coded standardized patient encounters. To estimate the potential benefit of the empathic
communication skills module on patient reported outcomes, six patients (with smoking history) per participating
physician (3 patients before the physician has completed the training and 3 patients after the training) will
complete measures of perceived lung cancer stigma, perceived empathy, satisfaction with communication, and
psychological distress. Additionally, electronic medical records will be examined pre- and post-training to
examine rates of accepted referrals to the Tobacco Treatment Program and other psychosocial services. It is
expected that these pilot test findings will provide evidence for the feasibility, acceptability and promise of a
communication skills training intervention to improve physicians’ empathic communication and thereby reduce
stigma experienced by patients with lung cancer.
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