Ability of primary care physician's to break bad news: A performance based assessment of an educational intervention

Amiel, Gilad E.; Ungar, Lea; Alperin, Mordechai; Baharier, Zvi; Cohen, Robert; Reis, Shmuel

doi:10.1016/j.pec.2005.04.013

Cited by 57 publications

(34 citation statements)

References 19 publications

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“…When proposing a training course on the disclosure of a bad news, the format is either classical classroom-training sessions on communication skills training courses [11,[40][41][42][43] or classical training plus standardized patient intervention [44][45][46][47][48]. Our approach lies in providing a distance-learning self-training tool that is not expensive and more manageable and less time-consuming for physicians with an often-overwhelming schedule.…”

Section: Discussionmentioning

confidence: 99%

Development of a Web-Based Formative Self-Assessment Tool for Physicians to Practice Breaking Bad News (BRADNET) (Preprint)

Rat¹,

Ricci²,

Guillemin³

et al. 2017

Preprint

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Objective: Although most physicians in a medical setting have to deliver bad news, the skills of delivering bad news to patients have been given insufficient attention. Delivering bad news is a complex communication task that includes verbal and non-verbal skills, the ability to recognise and respond to patients' emotions and the importance of considering the patient environment such as culture and social level. How bad news is delivered can have consequences that may affect patients sometimes definitively.The goal of the project was to develop an online formative self-assessment tool for physicians to practice delivering bad news so as to minimize the deleterious effects of a poor way of disclosing bad news about a disease, whatever the disease.Methods: BReaking bAD NEws Tool (BRADNET) items were developed by using a review of the existing protocols and recommendations for delivering bad news and patient-physician communication assessment instruments and semi-structured interviews with patients and physicians. From this step, the themes were selected and then pooled before consensus on a good practices communication framework list. Items were then created from this list. To ensure that physicians found the BRADNET acceptable, understandable and relevant to their condition, the tool was refined by a working group of clinicians familiar with delivering bad news. The think-aloud approach was then used to explore the impact of the items and messages and why and how these messages could change physicians' relations with patients or how to deliver bad news. Finally, formative self-assessment sessions were constructed according to a double perspective of progression: a chronological progression of the disclosure of the bad news and the growing difficulty of items (difficulty concerning the expected level of self-reflection). Results:The good practices communication framework list consisted of 70 specific issues in breaking bad news pooled in 8 main domains: opening, preparing for the delivering bad news consultation, communication techniques, consultation content, attention, physician emotional management, shared decision making and relationship between the physician and the medical team. Following the construction of the items from this list, the items were extensively refined to make it more useful to the target audience.The BRADNET contains 71 items, each including a question, response options and a corresponding message. These 71 items were divided into 8 domains and assessed with 12 self-assessment sessions.2 Conclusion: The self-assessed training tool is Web-based. Its objective is to create a "space" for reflection. It contains items leading to self-reflection and messages introducing recommended communication behaviors. The interest in our approach lies in providing a distance-learning self-assessment tool that is not expensive and is more manageable and less time-consuming for physicians with often overwhelming schedules.

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Section: Discussionmentioning

confidence: 99%

Development of a Web-Based Formative Self-Assessment Tool for Physicians to Practice Breaking Bad News (BRADNET) (Preprint)

Rat¹,

Ricci²,

Guillemin³

et al. 2017

Preprint

View full text Add to dashboard Cite

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“…Bu çalışmada sunulacak olan ÖÇM, bir hekimin hastasına ya da hasta yakınlarına kötü haber verme durumunda kalabileceğinden hareketle açılmıştır. Kötü haber verme becerisi ile eğitim düzeyinin birbiri ile ilişkili olduğu saptanmıştır (6). Kötü haber verme, her hekimin bilmesi gereken ve mezuniyet öncesi tıp eğitimi kapsamında da yer alması önerilen önemli bir konudur (7,8).…”

Section: Introductionunclassified

Bi̇r Özel Çalişma Modülü Deneyi̇mi̇: Hastaya Kötü Haber Verme

Boz¹,

Muslu²,

Badem³

et al. 2016

Tıp Eğitimi Dünyası

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ÖZET: Özel Çalışma Modülleri (ÖÇM), bilimsel yöntemin temellerini ve bilgiye ulaşım yollarını öğretmeyi amaçlayan, öğrenciyi derinlemesine öğrenmeye teşvik eden ve öğrencileri bu konularda geliştiren eğitimsel etkinliklerdir. ÖÇM'lerde çalışılan konular, eğitim programıyla paralellik gösterebildiği gibi, sağlık alanının sosyal yönüyle ilgili konuları da kapsayabilmektedir. Tıp fakültelerinin programlarında ÖÇM'ye yer verilmesinin gerekliliği ulusal ve uluslararası birçok rehberde belirtilmektedir. Dokuz Eylül Üniversitesi Tıp Fakültesi'nde ÖÇM'ler, 1998-1999 eğitim yılından bu yana eğitimin ilk 3 yılında yer almaktadır. Öğrenciler, öğretim üyelerince önerilen ÖÇM konuları arasından tercih yapmakta ve tercihlerinden birine yerleştirilmektedir. ÖÇM'lerden beklenen kazanımlar her bir yıl için farklılık göstermektedir. İlk yıl yayın derleme, ikinci yıl araştırma yapma ya da sosyal sorumluluk projesi, üçüncü yıl yayın derleme, araştırma yapma ve sosyal sorumluluk projesi alanında ÖÇM'ler önerilebilmektedir. Bu makalede sunulacak ÖÇM çalışması, bir yayın derleme ÖÇM'si olup bir hekimin hastasına ya da hasta yakınlarına kötü haberi iletmesi hakkındadır. Bir hekim için hastaya kötü haberi iletme biçimi çok büyük önem taşımaktadır. Çünkü hekimin tutum ve davranışları hastanın gelecek yaşamını, tedaviye bakış açısını doğrudan etkileyebilmektedir. Bu yüzden kötü haber, hastaya özel bir yolla verilmelidir. Bu ÖÇM çalışması biryandan birer hekim adayı olan Dönem 1 öğrencilerine bu konuda farkındalık kazandırmayı, diğer yandan da bilimsel kaynaklara ulaşma, bilgiyi yorumlayabilme, bilimsel metin yazabilme, sunum yapabilme, poster hazırlayabilme ve makale yazabilme konularında becerilerinin geliştirilmesini amaçlamaktadır. ÖÇM çalışmasında eğitim programında ayrılan zaman dilimlerinde öğrencilerle eğitim yönlendiricisinin buluştuğu 7 oturum yapılmıştır. İlk oturumlarda kaynak tarama, alıntı yapma ve yayın derlemenin kuralları üzerinde durulmuş, ilerleyen oturumlarda derlemelerini ve sunumlarını oluşturarak gruba sunmuş ve ÖÇM çalışmasına ilişkin poster hazırlamışlardır. Tüm bu aşamalarda gerek öğrenciler tarafından birbirlerine, gerekse öğretim üyesi tarafından öğrencilere verilen geribildirimler yol gösterici, geliştirici olmuştur. Oturumlar arasındaki zamanda da öğretim üyesi tarafından, yaptıkları hazırlıklar üzerinden öğrencilere geribildirim verilmiştir. Bu yazıda, ÖÇM çalışma süreci ayrıntılı bir biçimde verilmektedir.Anahtar Sözcükler: özel çalışma modülü, tıp eğitimi, kötü haber verme, bilgi kaynaklarına ulaşma, yayın derleme

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“…Many clinicians have difficulty, or lack the necessary skills in providing this type of care (Amiel et al, 2006;Dosanj et al, 2001). According to the findings from the studies assessing, interactions between patients and clinicians imply that the consequences of breaking bad news poorly can affect both the patient and the doctor involved (Baile et al, 2000;Stiefel et al, 2010;Walsh et al, 1998).…”

Section: Introductionmentioning

confidence: 99%

“…(Faulkner, 1998;Hawken, 2005;Abel et al, 2001Back et al, 2007. Many reports deal with the impact that bad news has on the deliverers (Brown et al, 2009) and the recipients (Amiel et al, 2006), and others contain useful guidelines and recommendations about what to do and say (Baile et al, 2000;Barnett, 2004;Buckman, 1992;Hawken, 2005). Therefore, in this study recommendations for facilitating breaking bad news were reviewed, and a suitable model was described for deliverers of bad news.…”

Section: Introductionmentioning

confidence: 99%

A Suitable Model for Breaking Bad News: Review of Recommendations

2014

JMED

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Most physicians experience difficulty when required to deliver bad news. Therefore, recommendations for facilitating breaking bad news were reviewed and a suitable model was described in this study. We performed a search with keywords "breaking bad news", "strategy", "protocol", "guideline" and "model" as the primary descriptors, and limiting the sources to English language articles with abstracts and guidelines, published since 1961 to March 2013. Two trained authors independently reviewed titles, abstracts and full texts of articles after a pilot inter-rater reliability assessment. All articles dealing specifically with breaking bad news were examined; they were descriptive and analytical studies. Recommendations and best models for facilitating breaking bad news from these articles were explored; sorted into discrete categories, summarized and framed as the best model for breaking bad news. The latest models, tools, steps and recommendations (e.g., delivering the bad news at a suitable and calm environment, giving the news with empathy and …) were examined. Although many articles have discussed the topic of breaking bad news, those that occurred repeatedly throughout these articles were summarized. Finally, the reference steps as according to the most important models for breaking bad news were presented. It is suggested that for more effective investigations, studies regarding interactional approaches in patients-medical team relationships be conducted on breaking bad news interventions.

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Ability of primary care physician's to break bad news: A performance based assessment of an educational intervention

Cited by 57 publications

References 19 publications

Development of a Web-Based Formative Self-Assessment Tool for Physicians to Practice Breaking Bad News (BRADNET) (Preprint)

Development of a Web-Based Formative Self-Assessment Tool for Physicians to Practice Breaking Bad News (BRADNET) (Preprint)

Bi̇r Özel Çalişma Modülü Deneyi̇mi̇: Hastaya Kötü Haber Verme

A Suitable Model for Breaking Bad News: Review of Recommendations

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