Breaking Bad News, a Pertinent Yet Still an Overlooked Skill: An International Survey Study

Alshami, Abbas; Douedi, Steven; Avila-Ariyoshi, America; Al-Azzawi, Mohammed; Patel, Swapnil; Einav, Sharon; Surani, Salim; Varon, Joseph

doi:10.3390/healthcare8040501

Cited by 15 publications

(16 citation statements)

References 21 publications

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“…Overall, the proportion of participants who received formal training on breaking bad news was slightly less than half 46.7% of the participants. This is comparable to the study conducted by Alshami et al in 2020, in which only (33.4%) of participants had reported that they received formal training on breaking bad news ( 15 ). The limitation in the proper training among healthcare providers may limit the communication capability between them and the patient.…”

Section: Dicsussionsupporting

confidence: 85%

Breaking Bad News During COVID-19 Time in Surgical, Emergency and Medical Specialties - What More we Need to Develop?

Khalaf¹,

Almothafar²,

Alhalabi³

2022

Med Arch

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Background: Breaking bad news is one of the complex communication skills essential to the practice of every clinician. It involves not only the mere provision of information, but also how to deal with the emotions of the patients and the response of their relatives. Therefore, certain protocols are employed for this process, including "BREAKS", "SPIKES", and “ABCDE” protocols. The emergence of the COVID-19 pandemic mandated the use of strict infection control measures including social distancing, requiring the utilization of telecommunication technologies for breaking bad news. Objective: The aim of the study was to assess the use on non-physical methods in breaking bad news by physicians and to evaluate the need for more development and training. Methods: Cross-sectional survey conducted in Kufa Medical College Al-Najaf during April - June 2021, and included 60 physicians of various specialties working in that hospital. Results: Majority of participants 88.3% reported breaking bad news regularly. Less than half of participants 46.7% received training on breaking bad news, and only 13.3% received training on non-physical breaking bad news. More than half of participants mentioned that showing empathy is the area that needs improvement the most. Conclusion: High proportion of physicians lacks the necessary skills to break bad news, especially using non-physical ways during the pandemic. Well-structured programs are needed for the training of healthcare providers on breaking bad news, with certain adaptations for traditional protocols to be appropriate for telephone or video conferencing.

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Section: Dicsussionsupporting

confidence: 85%

Breaking Bad News During COVID-19 Time in Surgical, Emergency and Medical Specialties - What More we Need to Develop?

Khalaf¹,

Almothafar²,

Alhalabi³

2022

Med Arch

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“…Evidence shows the effectiveness of communication skills training on patient outcomes and in supporting HCPs when breaking bad news 30 . However, research indicates that there is still a modest percentage of HCPs receiving formal training on how to deliver bad news and this continues to affect patients' care and their families 31 . Other research has shown that COPD patients were not seen by Respiratory Nurse Specialists who are best placed to provide a link to other specialist services including palliative care 32 .…”

Section: Comparison To Existing Literaturementioning

confidence: 99%

Communicating uncertainty: contrasting the communication experiences of patients with advanced COPD and incurable lung cancer

et al. 2021

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Background Due to the uncertain disease trajectory and variable rate of progression in chronic obstructive pulmonary disease (COPD), health care professionals (HCPs) are challenged in explaining what the future may hold for patients compared to those with lung cancer (LC). Support and communication of timely information can significantly improve health outcomes. Objective This study sought to identify factors that impact communication and support and recommend ways to improve patients’ understanding of living with life-threatening illness. Methods Semi-structured interviews with patients with LC (n = 22) and advanced COPD (n = 18), their informal carers (21 LC and 18 COPD) and HCPs (n = 51). Patients were recruited from primary and secondary care in the East of England, UK, during 2010–12. Results Directness and clarity characterized communication in LC, whereas uncertainty and limited explanations predominated in COPD. Discussions on how the disease might impact on decisions and preferences to be made in the future were less common in COPD. Information for LC patients was mainly from hospital clinicians and any information for COPD patients mainly from primary care clinicians. Conclusions The experience of COPD patients could be improved by professionals soon after diagnosis explaining to them the typical pattern of decline in COPD, highlighting the inherent uncertainties about when exacerbations and death may occur. This conversation should lead to planning for the different challenges that the patient and informal carer recognize as most important to them. This contrasts with the ‘breaking bad news’ conversation that oncologists are highly trained to deliver.

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“…In their international study, A. Alshami et al showed that only 26.6% of medical students received formal DBN training during their education [10]. The deficit of this type of instruction causes students to still report the need for in-depth training in this area [11,12].…”

Section: Introductionmentioning

confidence: 99%

“…However, still not enough students in the course of their education receive formal training developing skills related to DBN [ 8 , 9 ]. In their international study, A. Alshami et al showed that only 26.6% of medical students received formal DBN training during their education [ 10 ]. The deficit of this type of instruction causes students to still report the need for in-depth training in this area [ 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

Delivering Bad News: Self-Assessment and Educational Preferences of Medical Students

Lenkiewicz

Trzciński

et al. 2022

IJERPH

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Background: Numerous reports indicate the educational deficiencies of medical students in delivering bad-news-related skills. Evaluation of the performance of training programs in this area should be one of the key components of the educational process. The purpose of this study was to analyze medical students’ preferences and educational needs regarding DBN (delivering bad news). The effect of clinical experience on the self-assessment of skills was analyzed. Methods: The quantitative survey was conducted using the CAWI technique. The study involved 321 fifth- and sixth-year medical students from 14 medical universities in Poland. Pearson’s χ2 test was used for statistical analysis. The profile of respondents for categorical variables was determined by KMeans analysis. Results: As many as 75.1% of students revealed that they did not feel sufficiently prepared for DBN. Only 18.7% reported having adequate competence in this area. More than half of the inquired students (63.6%) witnessed a situation during their clinical practice in which a physician provided a patient with information about an unfavorable diagnosis. These students were less likely to declare that they could not deliver BN (43.4%) than students who had no such experience (58.2%). As many as 86.3% of the respondents reported the need for more time in DBN skills training. Students mostly preferred active teaching methods. Conclusions: Understanding students’ learning needs and preferences can help medical schools optimize their education programs to develop DBN-related competencies.

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Breaking Bad News, a Pertinent Yet Still an Overlooked Skill: An International Survey Study

Cited by 15 publications

References 21 publications

Breaking Bad News During COVID-19 Time in Surgical, Emergency and Medical Specialties - What More we Need to Develop?

Breaking Bad News During COVID-19 Time in Surgical, Emergency and Medical Specialties - What More we Need to Develop?

Communicating uncertainty: contrasting the communication experiences of patients with advanced COPD and incurable lung cancer

Delivering Bad News: Self-Assessment and Educational Preferences of Medical Students

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