Breaking bad news to patients with cancer: A randomized control trial of a brief communication skills training module incorporating the stories and preferences of actual patients

PATIENT EDUCATION AND COUNSELING

卷:100

Article

Gorniewicz, James¹  Floyd, Michael¹  Krishnan, Koyamangalath²  Bishop, Thomas W.¹  Tudiver, Fred¹  Lang, Forrest¹ 

[1] East Tennessee State Univ, Dept Family Med, POB 70621, Johnson City, TN 37614 USA

[2] East Tennessee State Univ, Dept Internal Med, POB 70621, Johnson City, TN 37614 USA

关键词: Breaking bad news;    Communication skills training;    Stories;    Narrative;    Common ground assessment;    Qualitative;    Cancer;    Objective structured clinical examination (OSCE);    Education;    Empathy;   

DOI  :  10.1016/j.pec.2016.11.008

来源: Elsevier

【 摘 要 】

Objective: This study tested the effectiveness of a brief, learner-centered, breaking bad news (BBN) communication skills training module using objective evaluation measures. Methods: This randomized control study (N = 66) compared intervention and control groups of students (n = 28) and residents' (n = 38) objective structured clinical examination (OSCE) performance of communication skills using Common Ground Assessment and Breaking Bad News measures. Results: Follow-up performance scores of intervention group students improved significantly regarding BBN (colon cancer (CC), p = 0.007, r = -0.47; breast cancer (BC), p = 0.003, r = -0.53), attention to patient responses after BBN (CC, p < 0.001, r = -0.74; BC, p = 0.001, r = -0.65), and addressing feelings (BC, p = 0.006, r = -0.48). At CC follow-up assessment, performance scores of intervention group residents improved significantly regarding BBN (p=0.004, r = -0.43), communication related to emotions (p = 0.034, r = -0.30), determining patient's readiness to proceed after BBN and communication preferences (p = 0.041, r = -0.28), active listening (p = 0.011, r = -0.37), addressing feelings (p < 0.001, r = -0.65), and global interview performance (p = 0.001, r = -0.51). Conclusion: This brief BBN training module is an effective method of improving BBN communication skills among medical students and residents. Practice implications: Implementation of this brief individualized training module within health education programs could lead to improved communication skills and patient care. (C) 2016 Elsevier Ireland Ltd. All rights reserved.

【 授权许可】

Free