Dataset Information

Breaking Bad News: A Small-Group Learning Module and Simulated Patient Case for Preclerkship Students.

ABSTRACT:

Introduction

Breaking bad news is a difficult skill that can elicit significant distress among learners. As such, it is important for learners to practice this skill in a controlled environment, which affords time to address any distress that arises and the opportunity to receive supportive feedback on performance. This breaking bad news module was designed for preclerkship students with previous training in basic communication skills and served as capstone to the preclerkship portion of the communication skills curriculum.

Methods

The small-group session was delivered to groups of 10-12 students and facilitated by a faculty member with expertise in communication skills. The small-group session included approximately 60 minutes of didactics and discussion, followed by a 30-minute faculty demonstration with simulated patients (SPs). Learners then had 30 minutes to practice with the SPs and received constructive feedback from the SPs and the faculty facilitator. Approximately 1 week following the small-group module, learners participated in an individual encounter with an SP and were assessed on physical examination skills and communication skills. Learners received detailed evaluations and feedback on breaking bad news skills from the SPs. Finally, learners had individual feedback meetings with their faculty facilitator, who reviewed the videotaped encounters, focusing on performance and experience of breaking bad news to the SP.

Results

In the 2015-2016 academic year, 217 medical students participated in this module. Learners demonstrated proficiency in the physical exam skills with 90% of learners asking about 5/8 components of the presenting complaint and 85% performing 5/8 physical exam maneuvers correctly. Similarly learners demonstrated expected levels of competence in interpersonal and communication skills.

Discussion

This learning exercise provided training in a critical communication skill but also supplied a framework for assessing and responding to personal and patient distress.

SUBMITTER: Cvengros JA

PROVIDER: S-EPMC6440412 | biostudies-literature | 2016 Nov

REPOSITORIES: biostudies-literature

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Publications

Breaking Bad News: A Small-Group Learning Module and Simulated Patient Case for Preclerkship Students.

Cvengros Jamie A JA Behel Jay M JM Finley Ellenkate E Kravitz Rebecca R Grichanik Mark M Dedhia Rupel R

MedEdPORTAL : the journal of teaching and learning resources 20161122

<h4>Introduction</h4>Breaking bad news is a difficult skill that can elicit significant distress among learners. As such, it is important for learners to practice this skill in a controlled environment, which affords time to address any distress that arises and the opportunity to receive supportive feedback on performance. This breaking bad news module was designed for preclerkship students with previous training in basic communication skills and served as capstone to the preclerkship portion of ...[more]

PMID: 30984847

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Project description:BackgroundIt is a crucial task for physicians to deliver life threatening information to patients (breaking bad news; BBN). Many aspects influence these conversations on both sides, patients, and doctors. BBN affects the patient-physician relationship, patients' outcome, and physicians' health. Many physicians are still untrained for this multi-facetted task and feel unprepared and overburdened when facing situations of BBN. Therefore, any faculties should aim to integrate communication skills into their medical curricula as early as possible. The SPIKES protocol is an effective framework to deliver BBN. Aim of this study is to evaluate the feasibility and obstacles of a BBN seminar and its acceptance and learning curve among undergraduate medical students.Methods158 2nd year undergraduate medical students attended a compulsory BBN seminar. The task was to deliver a cancer diagnosis to the patient within a patient - physician role-play in a gyneco-oncological setting before and after a presentation of the SPIKES protocol by the lecturer. The students evaluated important communication skills during these role-plays respectively. Self-assessment questionnaires were obtained at the beginning and end of the seminar.ResultsMost students indicated that their confidence in BBN improved after the seminar (p < 0.001). They like the topic BBN to be part of lectures (76%) and electives (90%). Communication skills improved. Lecturer and seminar were positively evaluated (4.57/5).ConclusionThe seminar significantly increased confidence and self-awareness in delivering life-threatening news to patients among undergraduate medical students. Important learning aspects of BBN and communication skills could be delivered successfully to the participants within a short time at low costs. The integration of communication skills should be implemented longitudinally into medical curricula starting before clinical education to increase the awareness of the importance of communication skills, to decrease anxiety, stress, and workload for future doctors and- most importantly- to the benefit of our patients.

Project description:BackgroundBreaking bad news (BBN; e.g., delivering a cancer diagnosis) is perceived as one of the most demanding communication tasks in the medical field and associated with high levels of stress. Physicians' increased stress in BBN encounters can negatively impact their communication performance, and in the long term, patient-related health outcomes. Although a growing body of literature acknowledges the stressful nature of BBN, little has been done to address this issue. Therefore, there is a need for appropriate tools to help physicians cope with their stress response, so that they can perform BBN at their best. In the present study, we implement the biopsychosocial model of challenge and threat as theoretical framework. According to this model, the balance between perceived situational demands and perceived coping resources determines whether a stressful performance situation, such as BBN, is experienced as challenge (resources > demands) or threat (resources < demands). Using two interventions, we aim to support medical students in shifting towards challenge-oriented stress responses and improved communication performance: (1) stress arousal reappraisal (SAR), which guides individuals to reinterpret their stress arousal as an adaptive and beneficial response for task performance; (2) worked examples (WE), which demonstrate how to BBN in a step-by-step manner, offering structure and promoting skill acquisition.MethodsIn a randomized controlled trial with a 2 (SAR vs. control) x 2 (WE vs. control) between-subjects design, we will determine the effects of both interventions on stress response and BBN skills performance in N = 200 third-year medical students during a simulated BBN encounter. To identify students' stress responses, we will assess their perceived coping resources and task demands, record their cardiovascular activity, and measure salivary parameters before, during, and after BBN encounters. Three trained raters will independently score students' BBN skills performances.DiscussionFindings will provide unique insights into the psychophysiology of medical students who are tasked with BBN. Parameters can be understood more comprehensively from the challenge and threat perspective and linked to performance outcomes. If proven effective, the evaluated interventions could be incorporated into the curriculum of medical students and facilitate BBN skills acquisition.Trial registrationClinicalTrials.gov (NCT05037318), September 8, 2021.

Dataset Information

Breaking Bad News: A Small-Group Learning Module and Simulated Patient Case for Preclerkship Students.

Introduction

Methods

Results

Discussion

Publications

Breaking Bad News: A Small-Group Learning Module and Simulated Patient Case for Preclerkship Students.

Similar Datasets

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