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

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.

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