Oncology Care Provider Training in Empathic Communication Skills to Reduce Lung Cancer Stigma

Smita C. Banerjee, Noshin Haque, Elizabeth A. Schofield, Timothy J. Williamson, Chloe M. Martin, Carma L. Bylund, Megan J. Shen, Maureen Rigney, Heidi A. Hamann, Patricia A. Parker, Daniel C. McFarland, Bernard J. Park, Daniela Molena, Aimee Moreno, Jamie S. Ostroff

Research output: Contribution to journalArticlepeer-review

17 Scopus citations


Background: Despite the clinical importance of assessing smoking history and advising patients who smoke to quit, patients with lung cancer often experience feelings of blame and stigma during clinical encounters with their oncology care providers (OCPs). Promoting empathic communication during these encounters may help reduce patients’ experience of stigma and improve related clinical outcomes. This paper presents the evaluation of OCP- and patient-reported data on the usefulness of an OCP-targeted empathic communication skills (ECS) training to reduce the stigma of lung cancer and improve communication. Research Question: What is the impact of the ECS intervention on OCPs’ communication skills uptake and patient-reported outcomes (lung cancer stigma, satisfaction with communication, and perceived OCP empathy)? Methods: Study subjects included 30 multidisciplinary OCPs treating patients with lung cancer who participated in a 2.25 h ECS training. Standardized Patient Assessments were conducted prior to and following training to assess ECS uptake among OCPs. In addition, of a planned 180 patients who currently or formerly smoked (six unique patients per OCP [three pretraining, three posttraining]), 175 patients (89 pretraining, 86 posttraining) completed post-OCP visit surveys eliciting feedback on the quality of their interaction with their OCP. Results: OCPs exhibited an overall increase in use of empathic communication skills [t(28) = –2.37; P < .05], stigma-mitigating skills [t(28) = –3.88; P < .001], and breadth of communication skill use [t(28) = –2.91; P < .01]. Patients reported significantly higher overall satisfaction with communication post-ECS training, compared with pretraining [t(121) = 2.15; P = .034; Cohen d = 0.35]. There were no significant differences from pretraining to posttraining for patient-reported stigma or perceived OCP empathy. Interpretation: Empathy-based, stigma-reducing communication may lead to improved assessments of tobacco use and smoking cessation for patients with smoking-related cancers. These findings support the dissemination and further testing of a new ECS model for training OCPs in best practices for assessment of smoking history and engagement of patients who currently smoke in tobacco treatment delivery.

Original languageEnglish (US)
Pages (from-to)2040-2049
Number of pages10
Issue number5
StatePublished - May 2021


  • communication skills training
  • empathic communication
  • lung cancer
  • oncology
  • satisfaction with communication
  • smoking
  • standardized patient assessment
  • stigma

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine


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