scholarly journals An Overview of Teaching Communication of Bad News in Medical School: Should a Lecture be Adequate to Address the Topic?

2016 ◽  
Vol 29 (12) ◽  
pp. 826 ◽  
Author(s):  
Filipe Coutinho ◽  
Anisha Ramessur
Keyword(s):  
Online Survey ◽  
Descriptive Analysis ◽  
Daily Practice ◽  
Bad News ◽  
Breaking Bad News ◽  
Step Method ◽  
Cross Sectional ◽  
Breaking Bad ◽  
Combination Approach ◽  
Delivering Bad News

Introduction: Delivering bad news is very common in medical daily practice. Several studies have shown a lack of effective communication skills amongst medical students, particularly concerning how to deliver bad news. The SPIKES protocol allows communicating bad news in a 6-step method. The aim of this study is to investigate the perspective of students related to this subject.Material and Methods: A 45 minute lecture “Breaking Bad News” was given to 160 students in the fifth and sixth years of the Medicine course, using the SPIKES’ protocol training. After the lecture, an online survey was given to all students, and a cross-sectional and descriptive analysis of data extracted from survey was undertaken.Results: Fifty-four students (21% of overall) answered the online survey. Eighty three percent said that theme should have an important role in their further daily medical practice, and most of students rated the physicians’ role as challenging. Sixty percent of students expressed that communicating bad news was an integral part of the medical course curriculum. Regarding the SPIKES´ protocol, 48% felt that the first step would be the easiest to put in practice, and 40% felt that the fifth step related to “Emotions” would be the most difficult.Discussion: In general, the students would like to gain competencies in breaking bad news using a practical approach Conclusions: Students highly valued theoretical and practical approaches in teaching of communication of bad news. Therefore, we encourage a combination approach in pre-graduate medical education.

scholarly journals Barriers and facilitating communication skills for breaking bad news: from the specialists’ practice perspective

1969 ◽  
Vol 40 (2) ◽  
pp. 158-166
Author(s):  
Enna Catalina Payán ◽  
David Andrés Montoya ◽  
John Jairo Vargas ◽  
María Clara Vélez ◽  
Alfonso Castaño ◽  
...  
Keyword(s):  
Action Plan ◽  
Point Of View ◽  
Communication Process ◽  
Bad News ◽  
Breaking Bad News ◽  
Cross Sectional ◽  
Breaking Bad ◽  
Survey Results ◽  
Level Of Knowledge ◽  
Delivering Bad News

Introduction: Breaking bad news is one of a physician’s most difficult duties. There are several studies related to the patient’s needs, but few reflect on the doctors’ experience. Materials and method: A descriptive, cross-sectional research was carried out to study issues related to the process of delivering bad news which might act as barriers and facilitating skills from the doctor’s point of view. These issues were identified through a self-administered survey. Results: Participant doctors use different strategies to communicate bad news to their patients. Examples of these strategies are: to be familiar with the patients’ medical history, to ensure that there is enough time, to know the patient’s caregivers and/or relatives, to determine the patient’s level of knowledge about his/her condition, to use non-technical words, to give information in small pieces, to assess the patient’s understanding, to devise a joint action plan, among others. Conclusion: The communication barriers that were identified focused on the emotional issues of the communication process, particularly those related to the recognition of own emotions, and the limited training about communication strategies available to doctors. Consequently, there is a need to implement training programs that provide doctors with tools to facilitate the bad news communication process.

scholarly journals Delivering Bad News to Patients: Survey of Physicians, Patients, and Their Family Members’ Attitudes

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Amir Bazrafshan ◽  
Asma Zendehbad ◽  
Seyed Ali Enjoo
Keyword(s):  
Negative Impact ◽  
Family Members ◽  
Cross Sectional Study ◽  
Bad News ◽  
Breaking Bad News ◽  
Cross Sectional ◽  
Breaking Bad ◽  
Medical News ◽  
Delivering Bad News

Background: Breaking bad news to patients is an unpleasant process, but it is essential for the medical team, which is giving information about a person’s illness; without proper planning, it leads to a negative impact on people’s feelings and quality of life. Cultural differences can be effective in telling bad news. Objectives: This study aimed to identify the attitudes of physicians, patients, and patients’ families towards breaking bad medical news. Methods: This cross-sectional study was performed among physicians, patients, and their families referred to Namazi Hospital, Shiraz, Iran, during 2016 - 2017. Their attitudes regarding how to tell bad news were evaluated by self-administrated questionnaires. Results: A total of 397 valid questionnaires completed by physicians, patients, and their families were analyzed in this study. All groups of participants preferred telling bad news to patients about the diagnosis of their disease; they also believed that in the case of a patient’s dissatisfaction, this information should not be given to other family members. Patients’ family members would rather tell lies to the patient about their diagnosis. Conclusions: There is a tendency towards not telling bad news in Iranian culture; Iranian people tend to protect those around them, and the desire to give bad news to those around them is lower than the tendency to hear bad news about one’s own illness. With increasing education, the tendency to telling bad news increases.

scholarly journals Breaking bad news of cancer diagnosis - the patient’s perspective

2017 ◽  
Vol 5 (4) ◽  
pp. 1617 ◽  
Author(s):  
Amod S. Dhage ◽  
Anne R. Wilkinson
Keyword(s):  
Tertiary Care ◽  
Cross Sectional Study ◽  
Bad News ◽  
Fundamental Aspect ◽  
Junior Resident ◽  
Breaking Bad News ◽  
Cross Sectional ◽  
Breaking Bad ◽  
Patient’S Perspective ◽  
Common Diagnosis

Background: Communication between physicians and patients is a fundamental aspect of cancer care. Bad news could be defined as "any information, which adversely affects an individual's view of his or her future”. The aim of the research study was to explore the patient’s perspective on receiving cancer news and their expectations regarding the same.Methods: A cross-sectional study was performed in our tertiary care teaching hospital. 50 consenting cancer patients from 18 to 60 years of age were interviewed on the basis of a structured, validated questionnaire.Results: On analysis of the 50 patients ‘answers, it was found that 37 were females and 13 were males, the average age being 50.07 years. The common diagnosis in females was breast cancer (20 patients) and in males it was lung cancer (5 patients). All the patients wanted relatives present with them when the bad news was broken to them.  In 66.6% patients, the news was broken by a junior resident, 15% of the doctors didn't greet the patients, 10% of the patients were told the news suddenly, while 99% of the doctors didn’t explain any positive aspects of the disease related to the treatment outcome.Conclusions: This study provides an insight into the expectations of patients from their physicians with regard to the process of breaking bad news.

scholarly journals Breaking bad news of cancer diagnosis – Perception of the cancer patients in a rural community in Malaysia

2014 ◽  
Vol 03 (02) ◽  
pp. 116-121 ◽  
Author(s):  
Mathew Gabriel Bain ◽  
Cheah Whye Lian ◽  
Chang Ching Thon
Keyword(s):  
Cancer Patients ◽  
Cancer Diagnosis ◽  
Current Method ◽  
Bad News ◽  
Breaking Bad News ◽  
Language Management ◽  
Cross Sectional ◽  
Breaking Bad ◽  
Information Giving ◽  
Significant Difference

Abstract Context: Breaking of bad news is an important component in the management of cancer patients. Aims: This study aimed to assess the perceptions of breaking bad news of cancer diagnosis. Settings and Design: It was a cross-sectional study using Breaking Bad News Assessment Schedule (BAS) questionnaire on cancer patients in Serian district. Materials and Methods: Using snowballing sampling method, a total of 134 patients were interviewed face-to-face after the consent was obtained from each of the respondents. Statistical Analysis Used: Data was entered and analyzed using SPSS version 19.0. Results: Majority were comfortable with the current method of breaking bad news. The main aspects found to be the areas of concern were the importance of the usage of body language, management of time and identifying patients′ key area of concerns. There were significant difference between sex and "information giving" (P = 0.028) and "general consideration" (P = 0.016) and also between "the age and setting the scene" (P = 0.042). Significant difference was also found between the types of cancer and "the setting of scene" (P = 0.018), "breaking bad news technique" (P = 0.010), "eliciting concerns" (P = 0.003) and "information giving" (P = 0.004). Conclusion: Good and effective communication skill of breaking bad news is vital in the management of cancer patients. As the incidence of new cases of cancer increase every year, breaking of bad news has become a pertinent to the medical professionals′ role. Specific aspects of communication skills based on local characteristics should be more emphasized in the formulation of training for doctors.

scholarly journals Training and Validation of Incognito Standardized Patients for Assessing Oncology Fellows’ Performance Regarding Breaking Bad News

2021 ◽  
Vol 14 (5) ◽  
Author(s):  
Mandana Shirazi ◽  
Amir Hossein Emami ◽  
Afsaneh Yakhforoshha
Keyword(s):  
Rating Scale ◽  
Reliability And Validity ◽  
Role Playing ◽  
Cross Sectional Study ◽  
Bad News ◽  
Breaking Bad News ◽  
Rater Agreement ◽  
Real Patient ◽  
Cross Sectional ◽  
Breaking Bad

Background: Standardized patient (SP) has been applied to measure learner’s communication challenges such as breaking bad news (BBN). When utilizing SP-based assessment, 2 steps should be considered in SP training; assessing SPs portrayal as the real patient (authenticity) and how SPs checklist fill out reproducibility. Objectives: In this study, we described the process of training authentic and consistent SPs for evaluating oncology fellows’ performance regarding BBN in Iran. Methods: In this cross-sectional study, 8 eligible SPs took part in a 3-day educational meeting. Four different scenarios were developed regarding cancer patients along with corresponding checklists representing common presentations of illness. The accuracy of SPs portrayal was evaluated by experts, using a previously validated rating scale during observation of their role-playing. The reproducibility of SPs’ portraits was measured, using a test-retest approach. The inter-rater agreement of the SPs’ ability to fill out the BBN scale was measured by comparing the correlation between the SPs, who completed the scale, and oncologist faculty members’ judgments, which is considered a gold standard. Results: The findings of this study indicated that the cut-off score for the SPs’ portrayal validity was 95%. The reliability of SPs portrayal was acceptable (r = 0.89). The inter-rater agreement between SPs and experts in filling the BBN scale (k = 0.82), as well as, the consistency of filling the BBN scale between SP groups were highly acceptable (k = 0.86). Conclusions: The present study has demonstrated that if SP is trained appropriately, they shave a high degree of reliability and validity to assess oncology fellows’ performance regarding BBN skills.

Breaking bad news from the doctors’ perspective in a paternalistic society: the case of Sudan

2018 ◽  
Vol 48 (4) ◽  
pp. 340-344 ◽  
Author(s):  
Mohamed S Muneer ◽  
Ahmed E Elhassan ◽  
Ahmed M Osman ◽  
Abdelmohaymin A Abdalla ◽  
Mohamed A Abdelrahim ◽  
...  
Keyword(s):  
Bad News ◽  
Breaking Bad News ◽  
Health Providers ◽  
Cross Sectional ◽  
Global Challenge ◽  
Breaking Bad ◽  
Attitude And Practice ◽  
The Right To Know ◽  
The Right ◽  
Previous Training

Breaking bad news is a global challenge for all types of health providers. Our study assessed the attitude and practice from the doctors’ perspective in a patriarchal society. A descriptive cross-sectional hospital-based study was conducted, involving doctors from both medical and surgical departments. Almost half of the respondents believed that Sudanese patients do not like to know their diagnosis, and a slightly higher proportion had no previous training on how to break bad news. Some 20% indicated that they would conceal the diagnosis from a patient if his or her relatives so requested. Less than one-quarter of respondents followed a standard protocol. Although most of the doctors subscribed to the notion that patients have the right to know everything about their illnesses, not all of them held this attitude towards their local patient population.

scholarly journals A standardized low-cost peer role-playing training intervention improves medical student competency in communicating bad news to patients in Botswana

2018 ◽  
Vol 17 (1) ◽  
pp. 60-65 ◽  
Author(s):  
Katherine D. Westmoreland ◽  
Francis M. Banda ◽  
Andrew P. Steenhoff ◽  
Elizabeth D. Lowenthal ◽  
Erik Isaksson ◽  
...  
Keyword(s):  
Medical Student ◽  
Medical Students ◽  
Low Cost ◽  
Role Playing ◽  
Bad News ◽  
Breaking Bad News ◽  
Multiple Choice Questions ◽  
Educational Training ◽  
Breaking Bad ◽  
Delivering Bad News

AbstractObjectiveThe purpose of this study was to demonstrate effectiveness of an educational training workshop using role-playing to teach medical students in Botswana to deliver bad news.MethodA 3-hour small group workshop for University of Botswana medical students rotating at the Princess Marina Hospital in Gaborone was developed. The curriculum included an overview of communication basics and introduction of the validated (SPIKES) protocol for breaking bad news. Education strategies included didactic lecture, handouts, role-playing cases, and open forum discussion. Pre- and posttraining surveys assessed prior exposure and approach to breaking bad news using multiple-choice questions and perception of skill about breaking bad news using a 5-point Likert scale. An objective structured clinical examination (OSCE) with a standardized breaking bad news skills assessment was conducted; scores compared two medical student classes before and after the workshop was implemented.ResultForty-two medical students attended the workshop and 83% (35/42) completed the survey. Medical students reported exposure to delivering bad news on average 6.9 (SD = 13.7) times monthly, with 71% (25/35) having delivered bad news themselves without supervision. Self-perceived skill and confidence increased from 23% (8/35) to 86% (30/35) of those who reported feeling “good” or “very good” with their ability to break bad news after the workshop. Feedback after the workshop demonstrated that 100% found the SPIKES approach helpful and planned to use it in clinical practice, found role-playing helpful, and requested more sessions. Competency for delivering bad news increased from a mean score of 14/25 (56%, SD = 3.3) at baseline to 18/25 (72%, SD = 3.6) after the workshop (p = 0.0002).Significance of resultsThis workshop was effective in increasing medical student skill and confidence in delivering bad news. Standardized role-playing communication workshops integrated into medical school curricula could be a low-cost, effective, and easily implementable strategy to improve communication skills of doctors.

scholarly journals Perspectives of Protocol Based Breaking Bad News among Medical Patients and Physicians in a Teaching Hospital, Ethiopia

2020 ◽  
Vol 30 (6) ◽  
Author(s):  
Henok Fisseha ◽  
Wudneh Mulugeta ◽  
Rodas A Kassu ◽  
Temesgen Geleta ◽  
Hailemichael Desalegn
Keyword(s):  
Patient Satisfaction ◽  
Patient Preference ◽  
Clinical Care ◽  
Communication Process ◽  
Bad News ◽  
Breaking Bad News ◽  
Medical Patients ◽  
Cross Sectional ◽  
Breaking Bad ◽  
Communication Task

BACKGROUND፡ Discussing potentially bad outcomes is a standard communication task in clinical care. Physicians’ awareness on ways to communicate bad news is considered low. SPIKES protocol is the most popular strategy used by physicians, but its practice and patients' perception are not known. This study attempted to fill the knowledge gap on protocol implementation, patient preference and physician effects.METHODS: Hospital-based descriptive cross-sectional study was conducted at SPHMMC from May 1 to June 30 using structured interviews administered to patients and physicians. Three hundred and sixty patients and 111 physicians were included. Assessment of SPIKES performance, patient satisfaction, patient preference, and physician awareness, attitude and effects were studied.RESULTS: Performance of SPIKES protocol was setting (74.5%), perception (51.1%), invitation (56.3%), knowledge (15.9%), emotion (22.3%) and summary (10.1%). Only 30.6% of the patients were entirely satisfied with the interaction, and 19.2% with knowledge attained. Patient satisfaction was associated with physician asking how much information they like (P=0.025). Patient desire and report showed variation. Eighty-two percent of the physicians were not aware of the protocol, and 83.8% had no training. Half of the physicians feel depressed after disclosure.CONCLUSIONS: Patient satisfaction with communication process and knowledge is poor, as is performance of SPIKES components. Satisfaction is related to being asked how much patients want to know. Patients’ desires on how to be told news is different from how it is done. Breaking bad news increases feeling of depression. Awareness and training on the protocol are deficient; medical schools should incorporate it into their studies and implement proper follow-up. 

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