Breaking bad news: an active learning method for medical students.

Humans Students, Medical / psychology Problem-Based Learning Truth Disclosure Female Male Physician-Patient Relations Communication Education, Medical, Undergraduate / methods Educational Measurement Clinical Competence
Announcement Breaking bad news Discussion group Objective structured clinical examination (OSCE) S-P-w-ICE-S protocol

Journal

BMC medical education
ISSN: 1472-6920
Titre abrégé: BMC Med Educ
Pays: England
ID NLM: 101088679

Informations de publication

Date de publication:
12 Sep 2024
Historique:
received: 13 03 2024
accepted: 25 07 2024
medline: 13 9 2024
pubmed: 13 9 2024
entrez: 12 9 2024
Statut: epublish

Résumé

Breaking bad news is one of the most difficult aspects of communication in medicine. The objective of this study was to assess the relevance of a novel active learning course on breaking bad news for fifth-year students. Students were divided into two groups: Group 1, the intervention group, participated in a multidisciplinary formative discussion workshop on breaking bad news with videos, discussions with a pluri-professional team, and concluding with the development of a guide on good practice in breaking bad news through collective intelligence; Group 2, the control group, received no additional training besides conventional university course. The relevance of discussion-group-based active training was assessed in a summative objective structured clinical examination (OSCE) station particularly through the students' communication skills. Thirty-one students were included: 17 in Group 1 and 14 in Group 2. The mean (range) score in the OSCE was significantly higher in Group 1 than in Group 2 (10.49 out of 15 (7; 13) vs. 7.80 (4.75; 12.5), respectively; p = 0.0007). The proportion of students assessed by the evaluator to have received additional training in breaking bad news was 88.2% (15 of the 17) in Group 1 and 21.4% (3 of the 14) in Group 2 (p = 0.001). The intergroup differences in the Rosenberg Self-Esteem Scale and Jefferson Scale of Empathy scores were not significant, and both scores were not correlated with the students' self-assessed score for success in the OSCE. Compared to the conventional course, this new active learning method for breaking bad news was associated with a significantly higher score in a summative OSCE. A longer-term validation study is needed to confirm these exploratory data.

Sections du résumé

BACKGROUND BACKGROUND
Breaking bad news is one of the most difficult aspects of communication in medicine. The objective of this study was to assess the relevance of a novel active learning course on breaking bad news for fifth-year students.
METHODS METHODS
Students were divided into two groups: Group 1, the intervention group, participated in a multidisciplinary formative discussion workshop on breaking bad news with videos, discussions with a pluri-professional team, and concluding with the development of a guide on good practice in breaking bad news through collective intelligence; Group 2, the control group, received no additional training besides conventional university course. The relevance of discussion-group-based active training was assessed in a summative objective structured clinical examination (OSCE) station particularly through the students' communication skills.
RESULTS RESULTS
Thirty-one students were included: 17 in Group 1 and 14 in Group 2. The mean (range) score in the OSCE was significantly higher in Group 1 than in Group 2 (10.49 out of 15 (7; 13) vs. 7.80 (4.75; 12.5), respectively; p = 0.0007). The proportion of students assessed by the evaluator to have received additional training in breaking bad news was 88.2% (15 of the 17) in Group 1 and 21.4% (3 of the 14) in Group 2 (p = 0.001). The intergroup differences in the Rosenberg Self-Esteem Scale and Jefferson Scale of Empathy scores were not significant, and both scores were not correlated with the students' self-assessed score for success in the OSCE.
CONCLUSION CONCLUSIONS
Compared to the conventional course, this new active learning method for breaking bad news was associated with a significantly higher score in a summative OSCE. A longer-term validation study is needed to confirm these exploratory data.

Identifiants

DOI: 10.1186/s12909-024-05821-4 PMID: 39267024
pubmed: 39267024
doi: 10.1186/s12909-024-05821-4
pii: 10.1186/s12909-024-05821-4
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

994

Informations de copyright

© 2024. The Author(s).

Références

Jalali R, Jalali A, Jalilian M. Breaking bad news in medical services: a comprehensive systematic review. Heliyon. 2023;9(4):e14734.
doi: 10.1016/j.heliyon.2023.e14734
Abel J, Dennison S, Senior-Smith G, Dolley T, Lovett J, Cassidy S. Breaking bad news–development of a hospital-based training workshop. Lancet Oncol. 2001;2(6):380–4.
doi: 10.1016/S1470-2045(00)00393-4
Buckman R. Breaking bad news: why is it still so difficult? Br Med J Clin Res Ed. 1984;288(6430):1597–9.
doi: 10.1136/bmj.288.6430.1597
Gilbey P. Qualitative analysis of parents’ experience with receiving the news of the detection of their child’s hearing loss. Int J Pediatr Otorhinolaryngol. 2010;74(3):265–70.
doi: 10.1016/j.ijporl.2009.11.017
Warrier V, Pradhan A. A narrative review of interventions to teach medical students how to Break Bad News. Med Sci Educ. 2020;30(3):1299–312.
doi: 10.1007/s40670-020-01015-x
VandeKieft GK. Breaking bad news. Am Fam Physician. 2001;64(12):1975–8.
TAN KKY, PANG A, KANG JX. Breaking bad news with CONSOLE: toward a framework integrating medical protocols with crisis communication. Public Relat Rev. 2019;45(1):153–66.
doi: 10.1016/j.pubrev.2018.10.013
de Moura Villela EF, Bastos LK, de Almeida WS, Pereira AO, de Paula Rocha MS, de Oliveira FM, et al. Effects on Medical students of Longitudinal Small-Group learning about breaking Bad News. Perm J. 2020;24(2):19157.
doi: 10.7812/TPP/19.157
Narayanan V, Bista B, Koshy C. BREAKS’ protocol for breaking Bad News. Indian J Palliat Care. 2010;16(2):61–5.
doi: 10.4103/0973-1075.68401
Rosenzweig MQ. Breaking bad news: a guide for effective and empathetic communication. Nurse Pract. 2012;37(2):1–4.
doi: 10.1097/01.NPR.0000408626.24599.9e
Meitar D, Karnieli-Miller O. Twelve tips to manage a breaking bad news process: using S-P-w-ICE-S - A revised version of the SPIKES protocol. Med Teach. 2022;44(10):1087–91.
doi: 10.1080/0142159X.2021.1928618
Baile WF, Buckman R, Lenzi R, Glober G, Beale EA, Kudelka AP. SPIKES-A six-step protocol for delivering bad news: application to the patient with cancer. Oncologist. 2000;5(4):302–11.
doi: 10.1634/theoncologist.5-4-302
Graffam B. Active learning in medical education: strategies for beginning implementation. Med Teach. 2007;29(1):38–42.
doi: 10.1080/01421590601176398
Rosenberg M. Society and the adolescent self-image. Princeton, NJ: Princeton University Press; 1965. p. 326.
doi: 10.1515/9781400876136
Vallieres EF, Vallerand RJ. Traduction Et Validation Canadienne-Française De L’échelle De L’estime De Soi De Rosenberg*. Int J Psychol. 1990;25(2):305–16.
doi: 10.1080/00207599008247865
Blanco JM, Caballero F, García FJ, Lorenzo F, Monge D. Validation of the Jefferson Scale of Physician Empathy in Spanish medical students who participated in an early clerkship immersion programme. BMC Med Educ. 2018;18(1):1–11.
doi: 10.1186/s12909-018-1309-9
McTighe AJ, DiTomasso RA, Felgoise S, Hojat M. Correlation between standardize patients’ perceptions of Osteopathic Medical students and students’ self-rated Empathy. J Am Osteopath Assoc. 2016;116(10):640–6.
Hojat M, DeSantis J, Shannon SC, Mortensen LH, Speicher MR, Bragan L, et al. The Jefferson Scale of Empathy: a nationwide study of measurement properties, underlying components, latent variable structure, and national norms in medical students. Adv Health Sci Educ. 2018;23(5):899–920.
doi: 10.1007/s10459-018-9839-9
Shanks A, Brann M, Bute J, Borse V, Tonismae T, Scott N. Breaking Bad News: a randomized trial assessing Resident Performance after Novel Video instruction. Cureus. 2021;13(6):e15461.
Hanya M, Kanno Y, Akasaki J, Abe K, Fujisaki K, Kamei H. Effects of communication skill training (CST) based on SPIKES for insurance-covered pharmacy pharmacists to interact with simulated cancer patients. J Pharm Health Care Sci. 2017;3(1):1–8.
doi: 10.1186/s40780-017-0080-0
Bosshard M, Schmitz FM, Guttormsen S, Nater UM, Gomez P, Berendonk C. From threat to challenge—improving medical students’ stress response and communication skills performance through the combination of stress arousal reappraisal and preparatory worked example-based learning when breaking bad news to simulated patients: study protocol for a randomized controlled trial. BMC Psychol. 2023;11(1):1–14.
doi: 10.1186/s40359-023-01167-6
Sobczak K, Trzciński M, Kotłowska A, Lenkiewicz J, Lenkiewicz O, Przeniosło J, et al. Delivering Bad News: emotional perspective and coping strategies of medical students. Psychol Res Behav Manag. 2023;16:3061–74.
doi: 10.2147/PRBM.S421995

Auteurs

Laura Polivka (L)

Department of Dermatology, Reference Center for Genodermatoses (MAGEC), Necker Hospital for Sick Children, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris Cité University, 149 rue de Sèvres, Paris, EU, 75015, France. laura.polivka@aphp.fr.

C Delcour (C)

Department of Obstetrical-Gynecology, Robert-Debré Hospital, AP-HP, Paris Cité University, Paris, EU, France.

H Dufresne (H)

Department of Dermatology, Reference Center for Genodermatoses (MAGEC), Necker Hospital for Sick Children, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris Cité University, 149 rue de Sèvres, Paris, EU, 75015, France.

S Bartoli (S)

General Pediatrics, Infectious Disease and Internal Medicine Department, Reference center for Rheumatic, AutoImmune and Systemic diseases in children (RAISE), Hôpital Robert-Debré, AP-HP, Paris Cité University, Paris, EU, France.

P Bataille (P)

Department of Dermatology, Reference Center for Genodermatoses (MAGEC), Necker Hospital for Sick Children, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris Cité University, 149 rue de Sèvres, Paris, EU, 75015, France.

L Bekel (L)

Department of Dermatology, Reference Center for Genodermatoses (MAGEC), Necker Hospital for Sick Children, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris Cité University, 149 rue de Sèvres, Paris, EU, 75015, France.

J Bonigen (J)

Department of Dermatology, Reference Center for Genodermatoses (MAGEC), Necker Hospital for Sick Children, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris Cité University, 149 rue de Sèvres, Paris, EU, 75015, France.

E Deladrière (E)

Department of Dermatology, Reference Center for Genodermatoses (MAGEC), Necker Hospital for Sick Children, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris Cité University, 149 rue de Sèvres, Paris, EU, 75015, France.

S Dimarcq (S)

Department of Dermatology, Reference Center for Genodermatoses (MAGEC), Necker Hospital for Sick Children, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris Cité University, 149 rue de Sèvres, Paris, EU, 75015, France.

A Felix (A)

General Pediatrics, Infectious Disease and Internal Medicine Department, Reference center for Rheumatic, AutoImmune and Systemic diseases in children (RAISE), Hôpital Robert-Debré, AP-HP, Paris Cité University, Paris, EU, France.
Department of General Pediatrics, RAISE Antilles-Guyane, Martinique University Hospital, Fort-de France, EU, France.

C Havas (C)

Department of Dermatology, Reference Center for Genodermatoses (MAGEC), Necker Hospital for Sick Children, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris Cité University, 149 rue de Sèvres, Paris, EU, 75015, France.

H Le Goff (H)

Department of Dermatology, Reference Center for Genodermatoses (MAGEC), Necker Hospital for Sick Children, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris Cité University, 149 rue de Sèvres, Paris, EU, 75015, France.

M Levy (M)

Paediatric Intensive Care Unit, Robert-Debré Hospital, AP-HP, Paris Cité University, Paris, EU, France.

E Riback (E)

Department of Dermatology, Reference Center for Genodermatoses (MAGEC), Necker Hospital for Sick Children, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris Cité University, 149 rue de Sèvres, Paris, EU, 75015, France.

A Welfringer-Morin (A)

Department of Dermatology, Reference Center for Genodermatoses (MAGEC), Necker Hospital for Sick Children, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris Cité University, 149 rue de Sèvres, Paris, EU, 75015, France.

V Houdouin (V)

Department of Pediatric Pulmonology and Pediatric Cystic Fibrosis Center, Robert-Debré Hospital, AP-HP, Paris Cité University, Paris, EU, France.

S Hadj-Rabia (S)

Department of Dermatology, Reference Center for Genodermatoses (MAGEC), Necker Hospital for Sick Children, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris Cité University, 149 rue de Sèvres, Paris, EU, 75015, France.

C Bodemer (C)

Department of Dermatology, Reference Center for Genodermatoses (MAGEC), Necker Hospital for Sick Children, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris Cité University, 149 rue de Sèvres, Paris, EU, 75015, France.

A Faye (A)

General Pediatrics, Infectious Disease and Internal Medicine Department, Reference center for Rheumatic, AutoImmune and Systemic diseases in children (RAISE), Hôpital Robert-Debré, AP-HP, Paris Cité University, Paris, EU, France.

I Melki (I)

General Pediatrics, Infectious Disease and Internal Medicine Department, Reference center for Rheumatic, AutoImmune and Systemic diseases in children (RAISE), Hôpital Robert-Debré, AP-HP, Paris Cité University, Paris, EU, France.
Paediatrics, Rheumatology and Paediatric Internal Medicine, Children's Hospital, Bordeaux, EU, F-33000, France.

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questionsmedicales.fr › Personnes › Étudiants › Étudiants des professions de santé › Étudiant médecine › Breaking bad news: an active learning method...
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questionsmedicales.fr › Sciences sociales › Sociologie › Révélation de la vérité › Breaking bad news: an active learning method...
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Prestations des soins de santé › Relations entre professionnels de santé et patients › Relations médecin-patient › Breaking bad news: an active learning method...
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questionsmedicales.fr › Éducation › Enseignement professionnel › Enseignement médical › Enseignement médical premier cycle › Breaking bad news: an active learning method...
questionsmedicales.fr › Éducation › Évaluation des acquis scolaires › Breaking bad news: an active learning method...
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Qualité des soins de santé › Compétence clinique › Breaking bad news: an active learning method...