Table 2 Oncologist communication behaviors targeted in the tailored educational intervention

Engaging

Oncologists are coached to (a) clarify the patient’s concerns early in the visit [52] – this corrects the tendency to address the first concern mentioned at the expense of more important issues [53], (b) acknowledge the Question Prompt List (QPL) to increase its effectiveness [26], (c) encourage questions, and (d) encourage participation in healthcare decision making [26, 54, 55].

Responding

Emotional expression and empathy are uncommon in oncology consultations [51, 56, 57]; therefore, oncologists are coached to respond to the emotional components of patients’ concerns with empathy and support.

Informing

Based on recent studies [58, 59], oncologists are coached to use an “Ask-Tell-Ask” protocol – asking patients about their wishes regarding information about prognosis and treatment choices, providing desired information in a desired format, and then checking patient understanding.

Framing

Based on recent studies [6, 58], oncologists are trained to present information for both optimistic or “best case” and pessimistic or “worst case” scenarios. Balanced information appears to better align patients’ and physicians’ efforts by reducing bias introduced by one-sided presentation of data.