Razavi 2003

Methods	RCT of follow‐up consolidation sessions after both groups had basic training.
Participants	63 physicians (62% oncologists) from Belgium hospitals, age 43+/‐7, 55% men, with average 14 years of experience in oncology and 43% no prior CST. All had participated in a 19‐hour CST workshop (consisting of two, 8‐hour/day sessions and one, 3‐hour evening session). 59 cancer patients, undergoing a 'breaking news' interview (67% women mean age 58 years). 53 cancer patients (65% women mean age 60 years) in encounters with relatives (48% women mean age 57 years).
Interventions	Six, 3‐hour per evening, bimonthly, consolidation sessions over three months.
Outcomes	HCP (doctors) outcomes: Communication skills: assessment skills (collecting information), information (giving) skills and supportive skills (empathy and emotional depth) were measured in audio‐taped SP 'breaking bad news' interviews and video‐taped RP interviews, rated using CRCWEM* before basic training and 5 months after training. Some interviews with accompanying significant other. Ability to detect distress (10‐point visual analogue scale). Patient outcomes: anxiety (STAI)*, anxiety and depression (HADS)*, perception of interview (PIQ)*. Significant other outcomes: anxiety (STAI)*, anxiety and depression (HADS)*.
Notes	There was no effect of consolidation workshops on doctors' ability to detect patient distress.
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	72 participants "randomly assigned".
Allocation concealment (selection bias)	Unclear risk	Not described.
Blinding of outcome assessment (detection bias) All outcomes	Low risk	Raters blinded for time (pre/post) and group.
Incomplete outcome data (attrition bias) All outcomes	Unclear risk	81% follow‐up for SP and RP; and 77% follow‐up for RP interview with significant other.
Selective reporting (reporting bias)	Low risk	All pre‐specified outcomes were reported.
Other bias	Low risk	Baseline characteristics of the two HCP groups were similar. Baseline scores of patient anxiety were markedly higher in patients seen by the control group.