Talking to migrant children and adolescents with cancer: development of a multimodal skills training in migrant-sensitive communication for paediatric oncologists.

Migration remains a risk factor for unequal treatment in the healthcare system. Communication plays a key role in bridging linguistic and sociocultural differences, particularly in medically complex and ethically demanding fields such as paediatric oncology. We aim to improve the quality of intercultural conversations between paediatric patients with life-threatening diseases, their parents, and physicians. This is a monocentric, single-blind, cluster randomised interventional feasibility trial which analysed intercultural conversations to develop a skills training programme in migrant-sensitive communication for paediatric oncologists using an interventional approach. Initially, 16 conversations were observed in a non-participatory, open external observation in order to develop an observation-and interview catalogue. 10 additional observations followed by 20 interviews (10 patient families and 10 paediatric oncologists) were conducted. Based on the findings of this qualitative analysis, a literature review, and an advisory board workshop, a multimodal skills training programme in migrant-sensitive communication was developed and conducted. The observations and interview analysis identified the need for training in communication, cultural competence, and interpreter-assisted conversations. The subsequently developed skills training consisted of three modules on cultural competence, ethical issues, and interpreter-assisted conversations. The practical training included conversation simulations using three scripted patient scenarios.

conclusionEven experienced paediatric oncologists identified a need to establish ongoing training in communication in an intercultural, family-centered setting and benefited from the multimodal training. WHAT IS KNOWN: • Communication barriers in the intercultural context may lead to substantial disadvantages in healthcare. • Medical patient-centered communication skills can be effectively improved through training. WHAT IS NEW: • Migrant children with cancer are particularly affected by communication deficits resulting from medical provider uncertainty regarding handling intercultural encounters. • Communication training aimed at continuously improving skills and attitudes is recommended as part of specialised medical training to overcome communication barriers.