General and Unique Communication Skills Challenges for Advanced Practice Providers: A Mixed-Methods Study

AIMS: Advanced practice providers are a rapidly growing sector of the health-care field. Despite their relatively new place in the medical establishment, these providers are held to high standards of education, practice, and communication skills. However, the communication needs of these practitioners are somewhat different than those of nurses or physicians. These skills are even more necessary in specialized fields where providers frequently are involved in discussions of prognosis, goals of care, and end of life. DESIGN: This was a mixed-methods study. METHODS: We completed a needs assessment of communication skills for advanced practice providers at a large cancer center in the northeastern United States from June to July 2017. RESULTS: Participants were confident in their skills across several areas of communication, but also endorsed the need for communication skills training, particularly for challenging interactions with patients and families. Advanced practice providers described many challenges similar to those descried by other health-care providers, including general communication skills problems, navigating team dynamics, and goals-of-care planning. However, participants also endorsed communication skills needs specific to their field, including certain patient-centered challenges, perceived/real limitations of their role, serving as the “middleman,” and understanding the advanced practice provider's role. CONCLUSION: Given the general and unique communication challenges advanced practice providers in oncology face, we conclude with recommendations for further institutional and educational changes to better address these needs.