August, 2006

Researchers receive $= 1.5 million NIH grant to study storytelling, cancer communication

Researchers at East Tennessee State University are weav= ing storytelling and medicine to teach effective communication skills to physic= ians and other healthcare providers who treat patients diagnosed with cancer.

A team of faculty from the James H. Quillen College of Medicine and the ETSU storytelling program in the Claudius G. Clemmer Colle= ge of Education has received a five-year, $1.5 million grant from the National= Institutes of Health’s National Cancer Institute to develop and assess a series = of interactive training modules that use stories from patients and clinicians.

“Discussions with cancer patients often involve delivering bad news, and dealing with life and death situations can present challenges for having effective communication. There are no better resources than the voices of patients when teaching physicians how to be effective in their communication,” said Dr. Forrest Lang, director of medical education and professor of Family Medicine. Dr. Lang will serve as Principal Investigator for the NIH-funded project.

Lang is part of a multidisciplinary team of researcher= s who will develop the training modules using videotaped interviews with cancer patien= ts. Topics to be addressed in the modules include:

Breaking Bad News
Weathering the Storm: Living through Treatment
Transitioning from Curative to Palliative End-of-Life Care
Appropriate Communications on Religious/Spiritual Factors in Cancer Care
Effective Communication and Support for Families of Cancer Patients.

Co-investigators joining Dr. Lang are K. Krishnan, MD,= chief of hematology and oncology and professor of Internal Medicine; Robert Enck,= MD, professor of Internal Medicine; Joseph Sobol, PhD, storytelling program coordinator and professor of Curriculum and Instruction; Fred Tudiver, MD, = director of primary care research and professor of Family Medicine; Beth Bailey, PhD= , associate professor of Family Medicine; Mike Floyd, EdD, professor of Family Medicine= ; Glenda Stockwell, PhD, assistant professor of Family Medicine; and Bruce Behringer, MPH, executive director for the office of rural and community health and community partnerships..

“Having a medical school and an academic storyte= lling program working together is a unique model, and it was because of this innovative partnership that we were able to obtain this major grant,”= Krishnan said. “Through our own research endeavors, including the Rural Appalachian Cancer Demonstration Project and other pilot studies, we learned several years ago that there were problems related to physician-patient communication. The data we collected became the foundation for this grant.”

In a 2007-2008 pilot study funded by the American Soci= ety of Clinical Oncology, 37 cancer patients were interviewed, and their stories a= re already being used for educational purposes. “One trend we found was = that there is no single best way to communicate with cancer patients about their disease,” Lang noted. “Some desire to talk about prognosis, oth= ers want to focus on hope, and there are some who just want honesty. It is important that the physician understand what the patient prefers.”

Effectiveness of the new modules will be tested with randomized groups of medical residents, fellows, and third-year medical students. The modules will eventually be available nationwide to programs and clinicians interested in improving cancer communication with t= heir patients.