Table 1.

Modular blueprint for responding empathically to patients: a communication skills training module to reduce lung cancer stigma

Strategies	Skills	Process tasks
1. Agenda setting	- Declare agenda - Normalize - Provide clinical rationale (for asking about smoking history) - Invite agenda - Negotiate agenda, if appropriate	- Greet patient appropriately - Make introductions - Ensure patient is clothed - Sit at eye-level
2. Questioning and history taking	- Ask open questions - Clarify - Restate	- Follow the list of questions for taking smoking history
3. Recognize or elicit a patient’s empathic opportunity	- Ask open questions (about smoking) - Acknowledge - Encourage expression of feelings	- Notice patient’s nonverbal communication
4. Work toward a shared understanding of the patient’s emotion/experience	- Ask open questions - Check patient understanding - Clarify - Restate	- Avoid leading questions/blaming statements - Avoid giving premature reassurance
5. Empathically respond to the emotion or experience	- Acknowledge - Validate patient struggle with tobacco dependence (will vary by smoking status) - Normalize nicotine addiction - Praise patient efforts	- Identify patient’s strengths and sources of support - Provide clear physician recommendation for quitting - Emphasize benefits of quitting
6. Facilitate coping and connect to social support	- Prepare patient for recurring smoking assessment - Suggest counterarguments (will vary by smoking status) - Invite questions	- Make referrals - Express a willingness to help - Make partnership statements
7. Close the conversation	- Praise patient efforts - Endorse question asking - Review next steps	- Reinforce joint decision-making

Goal: to enhance clinician recognition and responsiveness to lung cancer patients’ empathic opportunities by communicating understanding, alleviating stigma and distress, and providing support.