We currently have three programs underway: our flagship program on interdisciplinary communication, a newly launched program on educating cancer patients about symptom management while on oral oncolytic therapy, and a project investigating epistemic network analysis and shared understanding between physicians and nurses.

In front of computer patient checking records

Interdisciplinary Communication

Discussing about patient

Despite more than 50 years of research on the topic, poor communication between physicians and nurses remains one of the most frequent root causes of adverse events and a major challenge to improving patient safety. Effective communication involves the development of shared understanding that occurs in the moment-by-moment interaction between communicators. We have assessed the feasibility of using video reflexive ethnography to capture communication between physicians and nurses. During video review physicians and nurses focused on specific details of their communication practices, revealing their habits and gaps between what they said they did and what was actually done, providing the starting point to explore shared understanding.

Checking blood pressure

Improving Adherence to Oral Oncolytic Therapy in Cancer Patients

Nurse recording records

Over 1.7 million patients are diagnosed with cancer in the United States annually, and many will be prescribed oral medications to treat their cancer. Oral oncolytic therapy represents a new frontier in cancer treatment, but the convenience of oral oncolytics over intravenous chemotherapy infusions may be offset by the wide range of symptoms and side effects that patients experience. In one study, up to 30% of patients reported medication non-adherence to oral oncolytic therapy with symptoms as the primary reason, despite receiving education from oncology clinicians on evidence-based symptom management strategies. Through the use of VRE we will develop a better understanding of the best educational approaches that engage patients and their informal caregivers to manage treatment-related symptoms effectively. VRE will also help us explore the factors that interfere with patients’ abilities to process and internalize information during education sessions for application once they are at home.

Epistemic and Ordered Network Analysis

Epistemic network analysis (ENA) is a graph-based analytic technique that models the structure of connections in discourse data. We code the discourse data into eight codes corresponding to eight verbal response modes: edification, disclosure, advisement, question, confirmation, reflection, acknowledgement and interpretation. ENA produces network models that visually show the relative frequencies of these codes and co-occurrences between them. ENA models also allow aggregations and comparisons within and between groups (such as physicians and nurses). Ordered network analysis goes further to show the order of events unfolding over time, as well as the relative size of each coded verbal response mode in an interaction to provide greater insight into communication patterns and identify targets for improvement.