Helping patients to understand terrifying news: Addressing the inner lives of physicians and extending beyond what we know

Patient‐centered communication tool for older patients with acute myeloid leukemia, their caregivers, and oncologists: A single‐arm pilot study

“…This is not surprising given prognostic awareness is generally challenging to improve, and interventions to address prognostic awareness need to target multiple levels including the patient, caregiver, healthcare professional, societal, and systemic. 51 A future randomized controlled trial will evaluate the effect of the UR‐GOAL tool on SDM, communication, and other outcomes.…”

“…Of note, while prognostic awareness may have improved from baseline to post‐intervention, patients and caregivers remained more optimistic than the oncologists in perceptions of curability and life expectancy. This is not surprising given prognostic awareness is generally challenging to improve, and interventions to address prognostic awareness need to target multiple levels including the patient, caregiver, healthcare professional, societal, and systemic 51 . A future randomized controlled trial will evaluate the effect of the UR‐GOAL tool on SDM, communication, and other outcomes.…”

Dialysis Organization Online Information on Kidney Failure Treatments: A Content Analysis Using Corpus Linguistics

“… 52 Indeed, maintaining hope and truth telling are not mutually incompatible; in fact, because hope needs to be tied to what is attainable, misconstrued optimism “becomes detrimental if not tragic as the patient’s health declines and decisions about end-of-life care are made.” 53 Yet, it should be acknowledged that talking about prognosis can be difficult for physicians, and so, support for physicians in sharing prognostic information with patients (to the extent each patient wants it) is much needed. 54 …”

Why did he say that? Teaching physicians-in-training how to recognize hidden emotions in end-of-life prognosis conversations: an autoethnography

“…As we will see, this suggestion that doctors are lying to themselves again invokes the role of emotions underlying physicians’ prognostic communication. Although Al-Samkari and Patel 14 acknowledge the potential value of prognostic communication tools suggested by Abernethy et al , 9 they agree with Loh et al 15 on the greater importance of attacking the underlying issue: helping physicians overcome the emotional inertia causing them to avoid prognosis conversations altogether. Loh et al 15 stress the importance of emotional self-awareness training for physicians, and Al-Samkari and Patel 14 advocate working with the attending physicians leading fellowship programs so that they can learn emotional self-awareness for themselves and then inculcate it in their fellows.…”

“…Ofri and Groupman are not alone in their insistence on the importance of emotion for physicians navigating complex medical decisions with dying patients and families. The critical need for emotional self-awareness training to bring oncologist prognostication out of the “dark ages” 12 was identified above by Al-Samkari and Patel 14 and Loh et al 15 Additionally, in a study of physician residents’ interactions with surrogate decision makers, Reckrey, et al 23 found that “[r]esidents have complex and emotionally significant interactions” and “experienced significant emotional burden.” As a result of their findings, Dr. Reckrey and colleagues recommended that “educational efforts seek to help residents understand their own emotions and the ethical beliefs that underlie the roles they adopt ” in their interactions with healthcare decision makers (italics mine). This is a need that CPE “Verbatims” can fulfill.…”