Since 2005, Memorial Sloan Kettering’s innovative Comskil program has been teaching clinicians, across all disciplines, how to communicate with cancer patients and their families in challenging situations. As the nation’s first formally structured communication initiative at a comprehensive cancer center, the program aims to find the most effective and lasting approaches for guiding clinicians in serving patients across the cancer trajectory. Each year, more than 100 clinicians participate in our Comskil training program.
This unique program has a dedicated team of teachers, facilitators, and program staff. Training sessions consist of didactic lectures, followed by small group role play sessions with standardized patients led by experienced faculty and facilitators. We evaluate all trainings to continually improve participants’ experiences. Our facilities include a conference room and six state-of-the-art video-recording training rooms. Virtual training options are also available.
While the curriculum was developed for providing cancer care, it is adaptable for professionals in hospice settings, or those treating people with other chronic or critical health conditions.
Among the areas of instruction covered are:
- Sharing serious news
- Discussing prognoses and treatment options
- Responding to patient and caregiver anger
- Identifying and addressing palliative needs
- Handling issues related to end-of-life care, death, and dying
- Responding to challenging interactions with families
- Responding empathically to patients’ emotions and concerns
- Improving team communication
The Comskil program is primarily offered to nurses, faculty, medical trainees, advanced practice providers and other staff who regularly interact with patients at MSK. Training opportunities are occasionally offered to clinicians at other institutions as well. If you are interested in learning more, please contact the Comskil program at [email protected].
Bylund Cl, Brown RF, Bialer PA, Levin TT, Lubrano di Ciccone B, Kissane DW. Developing and implementing an advanced communication training program in oncology at a comprehensive cancer center. J Cancer Educ 2011 Dec;26(4):604-11.
Banerjee, S. C., Staley, J. M., Howell, F., Malling, C., Moreno, A., Kotsen, C., Parikh, D., & Parker, P. A. (2021). Communicating effectively via tele-oncology (Comskil TeleOnc): A guide for best practices for communication skills in virtual cancer care. Journal of Cancer Education : The Official Journal of the American Association for Cancer Education, 1–6. Advance online publication.
Cannity, K. M., Banerjee, S. C., Hichenberg, S., Leon-Nastasi, A. D., Howell, F., Coyle, N., Zaider, T., & Parker, P. A. (2021). Acceptability and efficacy of a communication skills training for nursing students: Building empathy and discussing complex situations. Nurse Education in Practice, 50, 102928.
Banerjee, S. C., Haque, N., Bylund, C. L., Shen, M. J., Rigney, M., Hamann, H. A., Parker, P. A., & Ostroff, J. S. (2021). Responding empathically to patients: A communication skills training module to reduce lung cancer stigma. Translational Behavioral Medicine, 11(2), 613–618.
Shen, M. J., Manna, R., Banerjee, S. C., Nelson, C. J., Alexander, K., Alici, Y., Gangai, N., Parker, P. A., & Korc-Grodzicki, B. (2020). Incorporating shared decision making into communication with older adults with cancer and their caregivers: Development and evaluation of a geriatric shared decision-making communication skills training module. Patient Education and Counseling, 103(11), 2328–2334.
Korc-Grodzicki, B., Alici, Y., Nelson, C., Alexander, K., Manna, R., Gangai, N., Shen, M. J., Parker, P. A., & Banerjee, S. C. (2020). Addressing the quality of communication with older cancer patients with cognitive deficits: Development of a communication skills training module. Palliative & Supportive Care, 18(4), 419–424.
Banerjee, S. C., Haque, N., Schofield, E. A., Williamson, T. J., Martin, C. M., Bylund, C. L., Shen, M. J., Rigney, M., Hamann, H. A., Parker, P. A., McFarland, D. C., Park, B. J., Molena, D., Moreno, A., & Ostroff, J. S. (2020). Oncology care provider training in empathic communication skills to reduce lung cancer stigma. Chest, S0012-3692(20)35308-3. Advance online publication.
Bylund CL, Banerjee SC, Bialer PA, Manna R, Levin TL, Parker PA, Schofield E, Li Y, Bartell A, Chou A, Hichenberg S, Dickler M, Kissane DW. A rigorous evaluation of an institutionally-based communication skills program for post-graduate oncology nurses. Patient Educ Couns 2018 Jun 1. pii: S0738-3991(18)30274-X.
Publications prior to 2017
Banerjee SC, Manna R, Coyle N, Penn S, Gallegos TE, Zaider T, Krueger CA, Bialer PA, Bylund CL, Parker PA. The implementation and evaluation of a communication skills training program for oncology nurses 2017. Transl Behav Med 2017 Sep;7(3):615-623.
Banerjee SC, Manna R, Coyle N, Johnson Shen M, Pehrson C, Zaider T, Hammonds S, Krueger CA, Parker PA, Bylund CL. Oncology nurses’ communication challenges with patients and families: A qualitative study. Nurse Educ Pract 2016 Jan;16(1):193-201.
Pehrson C, Banerjee SC, Manna R, Johnson Shen M, Hammonds S, Coyle N, Krueger CA, Maloney E, Zaider T, Bylund CL. Responding empathically to patients: Development, implementation, and evaluation of a communication skills training module for oncology nurses. Patient Educ Couns 2016 Apr;99(4):610-616.
Zaider TI, Banerjee SC, Manna R, Coyle R, Pehrson C, Hammonds S, Krueger CA, Bylund CL. Responding to Challenging interactions with families: A training module for inpatient oncology nurses. Fam Syst Health 2016 Sep;34(3):204-12.
Coyle N, Manna R, Shen M, Banerjee SS, Penn S, Pehrson C, Krueger CA, Maloney EK, Zaider T, Bylund CL. Discussing death dying and end-of-life goals of care: A communication skills training module for oncology nurses. Clin J Oncol Nurs 2015 Dec;19(6):697-7
As difficult as role playing is for me, it is such a great tool. The video experience, support from colleagues, and critique from the facilitators was a wonderful experience. You have managed to create a safe environment where real learning and acquisition of new skills can take place.
…I walked away feeling like I learned communication techniques that are just as important if not more important than clinical knowledge… In SACU, we communicate difficult news and have difficult conversations frequently. When our population requires an upgrade in care, it can elicit fear and anxiety and having the right answer on what to say in these situations is imperative. Sometimes we only have one shot to say the right thing and being trained in navigating difficult conversations can make a lasting impression for our patients and their families. I feel that since the Comskil course, I have had more structured and effective conversations with my patients and their families…
Very realistic and engaging role play that really made me evaluate my technique. Valuable session.
During training as a new SACU NP, we focused on the medical aspect of training but not as much the psychosocial aspect and dealing with families, which is such an important part of our job, especially for the ventilated patients. This course gave me the tools to effectively communicate with my patients and their families during difficult times and at end of life meetings.
This class was wonderful! I didn't realize it until I joined this class, but I have been feeling overwhelmed by hard conversations and feel that I've recently backed off on facilitating them as well as I was/could be. This has all given me more confidence and made me feel like I really can make a difference and help my patients get through situations. Every part of this course is invaluable…
…As clinical trials nurses we are often involved in difficult conversations and interactions, and we don't really have any standard training on how to handle these situations when they arise. I found all of the topics relevant, and have worked to incorporate them into my practice. I have >10 years of experience as a RN and found so much I could take back to my practice. It seems so simple, but the core communication cheat sheet has helped me prepare for interactions with patients/families I have had difficulty with in the past or to remind me of new options to try when I need to get more information from my patients…
Really good to go through this. A part of burnout is the emotional burden of end of life decision making, and we do it all the time in the ICU. Improving this skill and having a plan in advance to tackle these discussions is very helpful. It gives us tools in our toolbelt for navigating discussions.
Incredible communicators and teachers, thank you for the much needed experience! There should be several mandatory sessions like this a year, probably the most helpful and unique training out there.
It used to be that nobody ever actually really taught us how to have challenging conversations with our patients, but being able to communicate clearly and effectively is so fundamental to the art of medicine. The ability to teach and practice these skills is a tremendous resource, and integral to what we are and aspire to be at MSKCC.
It is an honor for me to participate in the Comskil program. Assisting residents and fellows in training to better understand the pearls and pitfalls of provider/patient communication is always exciting and gratifying. NYC is fortunately rich in theatrical talent, and the Comskil program offers an unparalleled opportunity for physicians, nurses, and allied health care professionals to grow, work on their skills in a safe and supportive environment, and learn from one another. As a facilitator, I learn as much, if not more, from the trainees and actors, about the many challenges we face in patient care in a cancer center, as I could ever offer the participants in the program.