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Psychooncology. 2017 May 5. doi: 10.1002/pon.4452. [Epub ahead of print]

Individual training at the undergraduate level to promote competence in breaking bad news in oncology.

Author information

1
Psychiatric Liaison Service, Lausanne University Hospital, Lausanne, Switzerland.
2
Faculty of Business and Economics, Lausanne University, Lausanne, Switzerland.
3
Medical Education Unit, Faculty of Biology and Medicine, Lausanne University, Lausanne, Switzerland.

Abstract

OBJECTIVE:

Training medical students in breaking bad news (BBN) in oncology may be key to improve patient care in an area where many physicians tend to be uncomfortable. Given the lack of evidence in the literature, this study aimed to assess empirically the impact of two teaching strategies to prepare students for the task of BBN in oncology: one-to-one simulated patient (SP) training with individual feedback (intervention group) vs. small-group SP training with collective feedback (comparison group).

METHODS:

Fourth-year students (N = 236) were randomly assigned to the intervention or comparison group. SP videotaped interviews were analyzed with respect to: BBN communication performance, rated using the Calgary-Cambridge checklist of teaching objectives for BBN; verbal interaction behaviors, coded with the Roter Interaction Analysis System; and seven nonverbal behaviors.

RESULTS:

Students in the intervention group scored significantly higher after than before the training on the overall evaluation of the interview (P < .001) as well as on process skills (P < .001); they also obtained significantly higher scores compared to students in the comparison group on the overall evaluation of the interview (P < .001) and on process skills (P < .001).

CONCLUSIONS:

This study supports an individualized BBN teaching strategy, and contributes to efforts to find the best way to train and reach the largest number of future physicians to improve communication competences in oncology.

KEYWORDS:

Breaking bad news; Communication Skills Training; cancer; communication; individual supervision; oncology; undergraduate medical education

PMID:
28477398
DOI:
10.1002/pon.4452
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