Background and aims: Based on our experience of communication skills trainings (CST) for oncology clinicians, we hypothesized that improvement in communication may be mediated by a modification of a clinician's defense mechanisms. In order to test this hypothesis, 120 oncology clinicians' interviews with simulated patients (60 interviews pre and 60 interviews post CST with a 6-month interval) are analyzed and compared to 120 interviews with simulated patients of a control group of 60 oncology clinicians who did not undergo CST (interval of 6 months).
Methods: Up to now, 20 oncology clinicians who underwent CST (13 nurses and 7 physicians) were included: 17 women and 3 men [mean age 38.2 (SD=8.5)]. Verbatim transcription of videotaped interviews were evaluated with the Defense Mechanism Rating Scales for therapists (DMRS-T), an adapted version of the DMRS.
Results: A total of 840 defenses mechanisms were observed in the 40 interviews (time 1 and time 2). The number of specific defense mechanisms ranged from 10 to 35 (M=21; SD=5.7). The three most frequent mechanisms were displacement (20.3%), intellectualisation (19.6%), and rationalization (16.1%). Results indicated an increase of the overall defense functioning (ODF) score [ODF 4.29 (SD=1.70)] vs. ODF 4.67 (SD=0.73, z=2.97, P=.003), an increase of neurotic defense mechanisms [50.15% (SD=1.41)] vs. 56.99% (SD=.98), z=2.27, P=.023), a decrease of immature defense mechanisms [45.21% (SD=1.28)] vs. 36.46% (SD=1.12, z=2.84, P=.005), and particularly, a decrease of bacting-outQ [9.91% (SD=.89)] vs. 4.38% (SD=.48, z=2.46, P=.014).
Conclusions: Preliminary results foster the hypothesis that CST may have an impact on the level of defense mechanisms.