Teaching Breaking Bad News Using Mixed Reality Simulation

Bowyer, Mark W.; Hanson, Janice L.; Pimentel, Elisabeth A.; Flanagan, Amy; Rawn, Lisa; Rizzo, Anne G.; Ritter, E. Matthew; Lopreiato, Joseph

doi:10.1016/j.jss.2009.04.032

Cited by 65 publications

(37 citation statements)

References 19 publications

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“…25,26 Studies exist, however, suggesting that long-term attainment of skills is possible by using this methodology. 2,14 We are currently examining methods to assess residents' communication skills in the clinical setting, pre-and post-PACE.…”

Section: Discussionmentioning

confidence: 99%

“…Review of the literature reveals this ubiquitous task is distressing for health care professionals and cites inadequate training, absence of supervisor support, and lack of skill as barriers to effectiveness. [1][2][3][4] Poorly communicated bad news can lead to patient and family misunderstanding, adjustment difficulties, negative attitudes toward health care providers, and decreased satisfaction with care. 1,[5][6][7] We sought to address this situation by developing a simulation-based curriculum to enhance the skills of health care professionals in communicating difficult news, hereafter termed relational crises.…”

Section: Introductionmentioning

confidence: 99%

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A Simulation-Based Curriculum To Address Relational Crises in Medicine

Peterson¹,

Porter²,

Calhoun³

2012

Journal of Graduate Medical Education

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Introduction Preparing health care professionals for challenging communication tasks such as delivering bad news to patients and families is an area where a need for improved teaching has been identified. Objectives We developed a simulation-based curriculum to enhance the skills of health care professionals, with an emphasis on the communication of difficult or bad news, which we termed relational crises. Methods Our approach was based on a review of existing simulation-based curricula, with the addition of unique features, including a learner-focused needs assessment to shape curriculum development, use of 360-degree evaluations, and provision of written feedback. Development and implementation of our curriculum occurred in 3 phases. Phase I involved a multidisciplinary needs assessment, creation of a clinical scenario based on needs assessment results, and training of standardized patients. In Phase II we implemented the curriculum with 36 pediatric and internal medicine-pediatrics residents, 20 nurses, and 1 chaplain. Phase III consisted of the provision of written feedback for learners, created from the 360-degree evaluations compiled from participants, observers, faculty, and standardized patients. Results Participants felt the scenarios were realistic (average rating of 4.7 on a 5-point Likert scale) and improved their practice and preparedness for these situations (average rating, 4.75/5 and 4.18/5, respectively). Our curriculum produced a statistically significant change in participants' pre- and postcurriculum self-reported perceptions of skill (2.42/5 vs. 3.23/5, respectively, P < .001) and level of preparedness (2.91/5 vs. 3.72/5, respectively, P < .001). Discussion A simulation-based curriculum using standardized patients, learner-identified needs, 360-degree evaluations, and written feedback demonstrated a statistically significant change in participants' self-perceived skills and preparedness for communicating difficult news in pediatrics.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A Simulation-Based Curriculum To Address Relational Crises in Medicine

Peterson¹,

Porter²,

Calhoun³

2012

Journal of Graduate Medical Education

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show abstract

“…These methods bring various levels of learning experience in an order from low to high. A mixture of the approaches is recommended and the general teaching design is of great importance (29).…”

Section: Insufficient Practicementioning

confidence: 99%

Communication skills training: Adapting to the trends and moving forward

Liu

Huang

Gao

et al. 2017

BST

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“…Another group of surgeons at Uniformed Services University developed a program for breaking bad news to families, but again this program has a surgical context. 16 Most of the existing end-of-life educational interventions, like ours, utilize the SPIKES Protocol. 17,18 The SPIKES Protocol is a 6-step strategy for breaking bad news that was developed based on a number of essential communication techniques listed in prior literature.…”

Section: Introductionmentioning

confidence: 99%

“…17 The content of the SPIKES protocol was found to be practical and easy to use by 99% of surveyed oncologists. 17 Many existing studies have used the SPIKES protocol to teach communication skills to both medical students and residents 10,14,16,24 across multiple medical specialties including surgery, 16,25 neurology, 26 and optometry. 27 The purpose of the present study was to develop and evaluate a program to enhance physicians' end-of-life communication with families of dying patients using the SPIKES protocol in a format that could be easily incorporated into an existing curriculum for first year internal medicine residents.…”

Section: Introductionmentioning

confidence: 99%