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Objective Providing a second opinion (SO) in oncology is complex, and communication during SOs remains poorly understood. This study aimed to systematically observe how patients and oncologists communicate about SO-specific topics (i.e., patient motivation, the referring oncologist, treatment transfer/back-referral), and how such communication affects patient satisfaction. Methods A prospective mixed-methods study of cancer patients seeking a SO (N = 69) and consulting oncologists was conducted. Before the SO, patients reported their expected place of future treatment. Following the SO, patients’ and oncologists’ satisfaction was assessed. All SOs were audio-recorded. Absolute and relative duration of SO-specific talk were calculated and specific events (e.g., questions/utterances) were coded (incl. valence, explicitness). Results SOs lasted 19–73 min, of which 3.7% was spent discussing motivations. Oncologists rarely explored patients’ motivations. Talk about referring oncologists (12.5% of consultation) was mostly critical by patients (M = 43.0%), but positive/confirming by consulting oncologists (M = 73.5%). Although 22.2% of patients expected a treatment transfer, this topic (3.3% of consultation time) was rarely explicitly discussed. Patients who were referred back were significantly less satisfied (d = 0.85). Conclusion Patient-provider communication in oncological SOs appears insufficiently aligned. Practice Implications Patients and oncologists need support to explicitly and productively communicate about SO-specific topics and to better manage expectations. Recommendations are provided.

Objective Experimental vignette designs are used to systematically test the effects of medical communication. We tested the impact of two methodological choices –gender congruence and vignette modality– on analogue patient reported outcomes. Methods In an online experiment using a vignette portraying an oncological bad news consultation, we manipulated (1) gender congruence between the analogue and the vignette patient, and (2) vignette modality, i.e., text, audio, or video. Cancer-naive students acting as analogue patients (N = 209, 22 ± 3 years old, 75% F) were assigned one randomly-selected vignette variant and completed questionnaires. Using 3 × 2 (repeated-measures) ANOVAs, we tested main and interaction effects of gender congruence and modality on self-reported engagement, recall, trust, satisfaction and anxiety. Results We found no main effects of gender congruence or modality on any of the outcomes, nor any interaction effects between modality and congruence. Conclusion Our results indicate that researchers may needlessly create gender-congruent vignettes at considerable cost and effort. Also, the currently assumed superiority of videos over other modalities for experimental vignette-based research may be inaccurate. Practice implications Although further testing in an offline format and among different populations is warranted, decisions regarding gender congruence and modality for future vignette-based studies should be based primarily on their specific aims.

Objective: To examine the association between whether physicians discuss the possibility of seeking a second opinion (SO) with patients and the patients' decision to seek an SO. We also investigated the impact of seeking such an opinion on patients' trust in physicians. Methods: Newly diagnosed breast cancer patients were surveyed postoperatively with a mail survey. A patient survey is carried out annually to evaluate the breast cancer centers in North Rhine-Westphalia, Germany. In 2016, survey data from 4517 patients in 87 hospitals were analyzed. Results: Physicians were more likely to inform patients under the age of 75 years with higher education levels about the possibility of seeking an SO. Our results indicate that requesting another opinion is associated with less trust in the physician. Conclusion: Our results indicate that physicians may selectively inform only a subset of patients about the possibility of seeking an SO. Patients who were informed about such a possibility are more likely to do so. Practice implications: Physicians may need to be careful to avoid inequalities based on the age and education of patients regarding giving information about the possibility of an SO. Moreover, breast cancer centers could provide material to patients regarding seeking an SO. (C) 2017 Elsevier B.V. All rights reserved

ObjectivesIn health communication research using video vignettes, it is important to assess viewers’ engagement. Engagement scores can indicate ecological validity of the design, and help distinguish between different engagement types. Therefore, we aimed to develop and validate a scale assessing viewers’ engagement with video vignettes.MethodsBased on an existing question set, the 15-item, five-dimensional Video Engagement Scale (VES) was developed. The VES was validated in two video-vignettes studies to investigate patient-physician communication. In addition to engagement, we assessed its presumed correlates, e.g., perceived realism of the video and identification with the patient.ResultsInternal consistency and test–retest reliability were adequate in both studies (N = 181 and N = 228). Positive correlations between the VES and perceived realism of the video, credibility of and identification with the patient suggested good content validity. Confirmatory factor analysis suggested a four-dimensional model fit, largely resembling our hypothesized model.ConclusionsThe VES reliably and validly measures viewers’ engagement in health communication research using video vignettes. It can be employed to assess ecological validity of this design. Further testing of the scale is needed to more solidly establish its dimensionality.Practice ImplicationsWe recommend that researchers use the VES, to ensure ecological validity of future video-vignettes studies.