Effects of a pre-visit online information tool about genetic counselling for ovarian cancer patients, a randomized controlled trial.

OBJECTIVE: In the Netherlands, patients with ovarian cancer are offered genetic testing. Pre-test preparation may help counseling patients. The aim of this study was to determine if use of a web-based intervention, leads to more effective genetic counseling of ovarian cancer patients. METHODS: Between 2016 and 2018, 127 ovarian cancer patients referred for genetic counseling in our hospital participated in this trial. 104 Patients were analyzed. All patients filled out questionnaires pre- and post-counseling. The intervention group also completed a questionnaire after visiting an online tool. Length of consultation, patients' satisfaction, knowledge, anxiety, depression and distress were compared before and after counselling. RESULTS: The intervention group had the same level of knowledge compared to the counseling group, but at an earlier point in time. They were satisfied with the intervention (86%) and better prepared for counseling (66%). The intervention did not lead to shorter consultations. No differences in levels of anxiety, depression, distress and satisfaction were observed. CONCLUSION: Although consultation length was unaffected, the improvements in knowledge after online education and patients satisfaction indicates that this tool can be an effective addition to genetic counseling. PRACTICE IMPLICATIONS: Use of an educational tool may lead to a more effective, personalized way of genetic counselling and enables shared decision making.

Training inter-physician communication using the Dynamic Patient Simulator.

PURPOSE: Clear and adequate communication between physicians is essential in modern medicine. Nevertheless, the medical curricula in The Netherlands lack an identifiable part in their education concerning inter-physician communication training. To train medical students in inter-physician communication skills using the Dynamic Patient Simulator (DPS), the Academic Medical Center at the University of Amsterdam and the Leiden University Medical Center joined in a 2-year project sponsored by the Dutch government. DPS is an educational computer program to create and simulate virtual patients with a wide variety of medical conditions in different clinical settings and over different time frames. To evaluate whether DPS is a suitable method for training medical students in inter-physician communication, we assessed if medical students felt that they had improved their inter-collegial communication skills after the pilot with DPS. Besides, we inquired students on DPS' usability and their satisfaction with DPS. METHODS: We first developed and implemented 20 patient simulations in DPS to be practiced upon by two students asynchronously during a week. These students were situated in different medical institutions, geographically spread over The Netherlands and had to treat the virtual patient as a team supported by DPS. The students had to report their findings and treatment plan in the electronic referral form of DPS. A total of 134 students participated in the pilot. To evaluate inter-physician communication training using DPS we conducted a survey amongst these students who were entering their internships. The evaluation focused on self-assessment of their communication skills, usability of the DPS program, and their satisfaction with DPS as educational format, using multiple questionnaires. DISCUSSION: The outcome of the evaluation showed significant progression in students' feeling of improvement of their skills in different aspects concerning the referral of a patient after participating in the pilot. Besides, students evaluated the usability of DPS positive and were highly satisfied with the education in inter-physician communication training using DPS. Based on these outcomes, nowadays this form of training is incorporated in the curricula on a regular basis.