Featured Research

from universities, journals, and other organizations

Clinicians: Learning to break the bad news

Date:
August 13, 2014
Source:
Society for Simulation in Healthcare
Summary:
Telling the patient and the family the bad news -- it's a daunting first-time experience for physicians and a staple of television medical dramas. But in real life, how do medical/health professionals learn to communicate a less than positive diagnosis or prognosis of an illness or -- even worse -- the death of a loved one? Recent studies in teaching approaches have been explored that seek to improve the necessary communications skills in breaking bad news.

Telling the patient and the family the bad news -- it's a daunting first-time experience for physicians and a staple of television medical dramas frequently portrayed as "There's a first time for everything. Just get out there and do it." But in real life, how do medical/health professionals learn to communicate a less than positive diagnosis or prognosis of an illness or -- even worse -- the death of a loved one?

Related Articles


Two papers published in the August issue of Simulation in Healthcare: the Journal of the Society for Simulation in Healthcare, explore recent studies in "real life" teaching approaches that seek to improve the necessary communications skills in breaking bad news.

In "Evaluation of the Impact of a Simulation-Enhanced Breaking Bad News Workshop in Pediatrics," medical educators report on a simulation-based training that, according to the ratings of participating pediatric residents, produced a 100% improvement in their communication skills. Most importantly, when evaluating the residents' post-workshop skills, parents who had previously received "bad news" and experts [a physician and bereavement social worker] reported improvement in 14 of 17 of the communications skills measured. Authors Kathleen Tobler, M.D., Estee Grant, M.D., and Cecile Marczinkski, PhD of Alberta Children's Hospital in Alberta, Canada, developed their simulation-based workshop -- which featured teaching scenarios with actors, observations, and debriefings -- because "the way news is communicated is highly memorable and has a significant impact on a family's coping and experience going forward." They also observed that "physicians consistently identify a desire and need for further education" in developing these communications skills.

The second article, "Teaching Communications Skills -- Using Action Methods to Enhance Role-Play in Problem-Based Learning," illustrates the use of structured techniques, including "action methods" brought from psychodrama and sociodrama. Authors Walter Baile, M.D. and Adam Blatner, M.D. at the University of Texas MD Anderson Cancer Center in Houston, TX, found such methods, including role-creation, doubling, role-reversal, group-processing, and role-training, can substantially enhance the effectiveness of role-play to teach communication skills for challenging conversations. A particularly effective method in creating empathy and group involvement is "doubling," where participants watching a role-play are invited to stand behind the chair occupied by the learner playing a character, imagine what the learner might be feeling or thinking, and speak their thoughts in the first person as if they were a voice-over or the learner's "alter-ego." The authors found this technique and the others they used can also reveal important unspoken thoughts and emotions. Attending to hidden feelings and thoughts and using self-reflection to anchor new learning can, for example, "raise awareness of how a doctor's own anxiety can lead them to avoid end-of-life discussions with patients and families or to be overly optimistic about available treatments."

The journal's founding and current editor-in-chief, David Gaba, M.D. of Stanford University School of Medicine and the Veterans' Administration Palo Alto Health Care System, notes that "people often think about simulation in terms of teaching the clinical and technical skills in healthcare, but it is increasingly being used to teach a variety of non-technical skills." He added that "these papers delve into the important skills of communication, whether with patients, families, or co-workers. I chose the first paper on bad news disclosure in pediatrics because it provides actual data on the impact of such training, and in a particularly challenging task; the second because it introduces "action methods" -- from psychodrama and socoiodrama -- that are new to the simulation community. While many of us use role-play in our simulation teaching, the additional techniques presented in these papers may greatly enhance our work."


Story Source:

The above story is based on materials provided by Society for Simulation in Healthcare. Note: Materials may be edited for content and length.


Journal References:

  1. Kathleen Tobler, Estee Grant, Cecile Marczinski. Evaluation of the Impact of a Simulation-enhanced Breaking Bad News Workshop in Pediatrics. Simulation in Healthcare: The Journal of the Society for Simulation in Healthcare, 2014; 9 (4): 213 DOI: 10.1097/SIH.0000000000000031
  2. Walter F. Baile, Adam Blatner. Teaching Communication Skills. Simulation in Healthcare: The Journal of the Society for Simulation in Healthcare, 2014; 9 (4): 220 DOI: 10.1097/SIH.0000000000000019

Cite This Page:

Society for Simulation in Healthcare. "Clinicians: Learning to break the bad news." ScienceDaily. ScienceDaily, 13 August 2014. <www.sciencedaily.com/releases/2014/08/140813173649.htm>.
Society for Simulation in Healthcare. (2014, August 13). Clinicians: Learning to break the bad news. ScienceDaily. Retrieved December 18, 2014 from www.sciencedaily.com/releases/2014/08/140813173649.htm
Society for Simulation in Healthcare. "Clinicians: Learning to break the bad news." ScienceDaily. www.sciencedaily.com/releases/2014/08/140813173649.htm (accessed December 18, 2014).

Share This


More From ScienceDaily



More Health & Medicine News

Thursday, December 18, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Kids Die While Under Protective Services

Kids Die While Under Protective Services

AP (Dec. 18, 2014) As part of a six-month investigation of child maltreatment deaths, the AP found that hundreds of deaths from horrific abuse and neglect could have been prevented. AP's Haven Daley reports. (Dec. 18) Video provided by AP
Powered by NewsLook.com
Dads-To-Be Also Experience Hormone Changes During Pregnancy

Dads-To-Be Also Experience Hormone Changes During Pregnancy

Newsy (Dec. 18, 2014) A study from University of Michigan researchers found that expectant fathers see a decrease in testosterone as the baby's birth draws near. Video provided by Newsy
Powered by NewsLook.com
Prenatal Exposure To Pollution Might Increase Autism Risk

Prenatal Exposure To Pollution Might Increase Autism Risk

Newsy (Dec. 18, 2014) Harvard researchers found children whose mothers were exposed to high pollution levels in the third trimester were twice as likely to develop autism. Video provided by Newsy
Powered by NewsLook.com
UN: Up to One Million Facing Hunger in Ebola-Hit Countries

UN: Up to One Million Facing Hunger in Ebola-Hit Countries

AFP (Dec. 17, 2014) Border closures, quarantines and crop losses in West African nations battling the Ebola virus could lead to as many as one million people going hungry, UN food agencies said on Wednesday. Duration: 00:52 Video provided by AFP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins