Self-assessment of residents in breaking bad news; skills and barriers

BMC Medical Education

Research

Razieh Salehian¹  Atefeh Ghanbari Jolfaei²  Mehdi Zandi³  Maryam Mansoursamaei⁴  Ali Mansoursamaei⁵ 

[1] Mental Health Research Center, Department of Psychiatry, School of Medicine, Psychosocial Health Research Institute, Rasoul-e-Akram Hospital, Iran University of Medical Sciences, 14456-13131, Tehran, Iran;Minimally Invasive Surgery Research Center, Department of Psychiatry, School of Medicine, Iran University of Medical Sciences, 14456-13131, Tehran, Iran;Student Research Committee, School of Medicine, Iran University of Medical Sciences, 14456-13131, Tehran, Iran;Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, 19857-17443, Tehran, Iran;Student Research Committee, School of Medicine, Shahroud University of Medical Science, 36147-73943, Shahroud, Iran;

关键词: Breaking bad news;    Giving bad news;    Delivering bad news;    Physicians;    Residents;    Barriers;   

DOI  :  10.1186/s12909-023-04720-4

 received in 2023-05-19, accepted in 2023-09-25,  发布年份 2023

来源: Springer

【 摘 要 】

IntroductionBreaking bad news (BBN) is inevitable in medicine and is one of the most important and difficult professional tasks of physicians. The main aims of this study are to evaluate residents’ practice of BBN and identify perceived barriers to its implementation.MethodsIn this cross-sectional study in 2021, 240 residents from medical, surgical, and emergency medicine departments completed the demographic questionnaire, the Persian SPIKES questionnaire (P-SPIKES), and the researchers-made questionnaire of Barriers to Breaking Bad News (BBBN). In addition, they were asked about their previous experience, previous training, and their perceived level of competence in BBN.Results46.5% and 36.84% of residents rated their perceived competence in BBN and managing the patient’s emotions during BBN as good or very good, respectively. The most difficult aspects of BBN for residents were expressing upsetting information (78.1%) and not disappointing the patient while being honest (58.3%). The mean and standard deviation of the score of the P- SPIKES was 55.92 ± 6.84. The most common SPIKES item was not giving bad news by phone (98.9%). The SPIKES total score was only related to age (positive relationship). The most commonly reported barriers to BBN were concerns about controlling the patient’s emotions (61%) and the aggressiveness of the patient or companions (52.6%). A significant proportion of participants identified lack of training (28%) and insufficient skills (21.9%) as significant barriers to BBN.ConclusionsThe skill of residents in BBN is insufficient in some aspects and points to the need for BBN training courses during residency. BBN is difficult for residents in some aspects and residents may perceive barriers. To overcome the existing barriers and increase residents’ confidence in BBN, strategies such as incorporating BBN training into residency educational curricula and communication skills are recommended.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

【 图 表 】

Fig. 3