Working alliance in communication skills training for oncology clinicians: A controlled trial

Objective

The aim of this study was to evaluate the impact of communication skills training (CST) on working alliance and to identify specific communicational elements related to working alliance.

Methods

Pre- and post-training simulated patient interviews (6-month interval) of oncology physicians and nurses (N = 56) who benefited from CST were compared to two simulated patient interviews with a 6-month interval of oncology physicians and nurses (N = 57) who did not benefit from CST. The patient–clinician interaction was analyzed by means of the Roter Interaction Analysis System (RIAS). Alliance was measured by the Working Alliance Inventory – Short Revised Form.

Results

While working alliance did not improve with CST, generalized linear mixed effect models demonstrated that the quality of verbal communication was related to alliance. Positive talk and psychosocial counseling fostered alliance whereas negative talk, biomedical information and patient's questions diminished alliance.

Conclusion

Patient–clinician alliance is related to specific verbal communication behaviors.

Practice implications

Working alliance is a key element of patient–physician communication which deserves further investigation as a new marker and efficacy criterion of CST outcome.