The Acknowledge-Normalize-Partner (ANP) Framework: A novel empathic communication tool for oncology nurses

Dana Kramer, Kimberly Chow, Mary Elizabeth Davis, Judith E. Nelson, Kelley Anderson, Molly Okpako, Camila Bernal, Catherine E. Malisse, Jessica I. Goldberg

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Objective To describe the development and implementation of a novel tool designed to enhance nurse-patient communication in a major academic cancer center, which nurses can learn quickly, incorporate into their primary palliative care practice, and broadly disseminate in order to improve the patient experience. Method An evidence-based empathic communication tool and educational program were designed to provide essential skills to oncology nurses in having discussions with patients about their personal values. Evaluation included nurse focus groups, pre- and post-course evaluations and interviews, and patient questionnaires. Results Nurses were satisfied with the educational program and found the communication tool effective in a variety of clinical situations including discussions about personal values. Patients reported increased occurrences of these discussions when nurses utilized the framework (97% vs. 58%, p < 0.0001) and a higher quality of clinician communication (mean [SD] from 0 = very worst to 10 = very best: 7.18 [2.3] vs. 5.04 [2.9], p = 0.001). Significance of results Skilled, empathic communication is an essential component of high-quality primary palliative care. Oncology nurses are well suited to lead communication and provide this care as part of an interprofessional team. The training and tool described here are targeted and efficient, and prepare nurses to respond skillfully to emotion while facilitating important discussions about patient values.

Original languageEnglish
Pages (from-to)12-19
Number of pages8
JournalPalliative and Supportive Care
Issue number1
StatePublished - 7 Feb 2023
Externally publishedYes


  • Communication skills training
  • Nurse-patient communication
  • Palliative care education
  • Primary palliative care


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