Advertisement

Journal of Cancer Education

, Volume 28, Issue 1, pp 187–191 | Cite as

Medical Students’ Skills and Needs for Training in Breaking Bad News

  • Friedrich StiefelEmail author
  • Céline Bourquin
  • Carine Layat
  • Sara Vadot
  • Raphael Bonvin
  • Alexandre Berney
Article

Abstract

This study assessed medical students’ perception of individual vs. group training in breaking bad news (BBN) and explored training needs in BBN. Master-level students (N = 124) were randomised to group training (GT)—where only one or two students per group conducted a simulated patient (SP) interview, which was discussed collectively with the faculty—or individual training (IT)—where each student conducted an SP interview, which was discussed during individual supervision. Training evaluation was based on questionnaires, and the videotaped interviews were rated using the Roter Interaction Analysis System. Students were globally satisfied with the training. Still, there were noticeable differences between students performing an interview (GT/IT) and students observing interviews (GT). The analysis of the interviews showed significant differences according to scenarios and to gender. Active involvement through SP interviews seems required for students to feel able to reach training objectives. The evaluation of communication skills, revealing a baseline heterogeneity, supports individualised training.

Keywords

Breaking bad news Medical students Individual vs. group training Communication skills Training needs 

Notes

Acknowledgments

This study was supported by the Fonds d’Innovation Pédagogique (FIP) of the University of Lausanne.

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Stiefel F, Barth J, Bensing J et al (2010) Communication skills training in oncology: a position paper based on a consensus meeting among European experts in 2009. Ann Oncol 21:204–207PubMedCrossRefGoogle Scholar
  2. 2.
    Fallowfield L (1993) Giving sad and bad news. Lancet 341:476–478PubMedCrossRefGoogle Scholar
  3. 3.
    Vetto JT, Elder NC, Toffler WL, Fields SA (1999) Teaching medical students to give bad news: does formal instruction help? J Cancer Educ 14:13–17PubMedGoogle Scholar
  4. 4.
    Baile WF, Kudelka AP, Beale EA et al (1999) Communication skills training in oncology. Description and preliminary outcomes of workshops on breaking bad news and managing patient reactions to illness. Cancer 86:887–897PubMedCrossRefGoogle Scholar
  5. 5.
    Hack TF, Degner LF, Parker PA (2005) The communication goals and needs of cancer patients: a review. Psycho-Oncology 14:831–845PubMedCrossRefGoogle Scholar
  6. 6.
    Fallowfield L, Jenkins V (2004) Communicating sad, bad, and difficult news in medicine. Lancet 363(9405):312–319PubMedCrossRefGoogle Scholar
  7. 7.
    Fallowfield L, Jenkins V, Farewell V et al (2002) Efficacy of Cancer Research UK communication skills training model for oncologists: a randomised controlled trial. Lancet 359(23):650–656PubMedCrossRefGoogle Scholar
  8. 8.
    Gysels M, Richardson A, Higginson IJ (2004) Communication training for health professional who care for patients with cancer: a systematic review of effectiveness. Support Care Cancer 12:692–700PubMedCrossRefGoogle Scholar
  9. 9.
    Stiefel F (ed) (2006) Communication in cancer care. Springer, BerlinGoogle Scholar
  10. 10.
    Butow P, Cockburn J, Girgis A et al (2008) Increasing oncologists’ skills in eliciting and responding to emotional cues: evaluation of a communication skills training program. Psycho-Oncology 17:209–218PubMedCrossRefGoogle Scholar
  11. 11.
    Liénard A, Merckaert I, Libert Y et al (2010) Is it possible to improve residents breaking bad news skills? A randomised study assessing the efficacy of a communication skills training program. Br J Cancer 103:171–177PubMedCrossRefGoogle Scholar
  12. 12.
    Langewitz W, Heydrich L, Nübling M, Szirt L, Weber H, Grossman P (2010) Swiss cancer league communication skills training programme for oncology nurses: an evaluation. JAN 66(10):2266–2277CrossRefGoogle Scholar
  13. 13.
    Kiss A (1999) Communication skills training in oncology: a position paper. Ann Oncol 10(8):899–901PubMedCrossRefGoogle Scholar
  14. 14.
    Rosenbaum ME, Ferguson KJ, Lobas JG (2004) Teaching medical students and residents skills for delivering bad news: a review of strategies. Acad Med 79:107–117PubMedCrossRefGoogle Scholar
  15. 15.
    Supiot S, Bonnaud-Antignac A (2008) Using simulated interviews to teach junior medical students to disclose the diagnosis of cancer. J Cancer Educ 23:102–107PubMedCrossRefGoogle Scholar
  16. 16.
    Bonnaud-Antignac A, Campion L, Pottier P, Supiot S (2010) Videotaped simulated interviews to improve medical students’ skills in disclosing a diagnosis of cancer. Psycho-Oncology 19:975–981PubMedCrossRefGoogle Scholar
  17. 17.
    Despland JN, Bernard M, Favre N, Drapeau M, de Roten Y, Stiefel F (2009) Clinicians’ defenses: an empirical study. Psychol Psychother Theor Res Pract 82:73–81CrossRefGoogle Scholar
  18. 18.
    Bernard M, Roten Y, Despland JN, Stiefel F (2010) Communication skills training and clinicians’ defenses in oncology: an exploratory, controlled study. Psycho-Oncology 19:209–215PubMedCrossRefGoogle Scholar
  19. 19.
    Roter D, Larson S (2002) The roter interaction analysis system (RIAS): utility and flexibility for analysis of medical interactions. Patient Educ Couns 46:243–251PubMedCrossRefGoogle Scholar
  20. 20.
    Roter D (2006) The Roter method of interaction process analysis. RIAS manual. John Hopkins University, BaltimoreGoogle Scholar
  21. 21.
    Roter D (2010) The Roter Interaction Analysis System (RIAS): applicability within the context of cancer and palliative care. In: Kissane D et al (eds) Handbook of communication in oncology and palliative care. Oxford University Press, Oxford, pp 717–726CrossRefGoogle Scholar
  22. 22.
    Mead N, Bower P (2000) Patient-centredness: a conceptual framework and review of the empirical litterature. So Sci Med 51(7):1087–1110CrossRefGoogle Scholar
  23. 23.
    Stewart M, Brown JB, Weston WW, McWhinny IR, McWilliam CL, Freeman TR (2003) Patient-centered medicine transforming the clinical method. Radcliffe Medical Press, AbingdonGoogle Scholar
  24. 24.
    De Haes H (2006) Dilemmas in patient centeredness and shared decision making: a case for vulnerability. Pat Educ Couns 62(3):291–298CrossRefGoogle Scholar
  25. 25.
    Schmid Mast M, Hall JA, Klöckner C, Choi E (2008) Physician gender affects how physician nonverbal behavior is related to patient satisfaction. Med Care 46:1212–1218CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2012

Authors and Affiliations

  • Friedrich Stiefel
    • 1
    Email author
  • Céline Bourquin
    • 1
  • Carine Layat
    • 2
  • Sara Vadot
    • 2
  • Raphael Bonvin
    • 2
  • Alexandre Berney
    • 1
  1. 1.Psychiatric Liaison ServiceLausanne University HospitalLausanneSwitzerland
  2. 2.Medical Education UnitFaculty of Biology and Medicine of the University of LausanneLausanneSwitzerland

Personalised recommendations