Psychiatric Liaison Service, Lausanne University Hospital, Lausanne, Switzerland.
Faculty of Business and Economics, Lausanne University, Lausanne, Switzerland.
Psychooncology. 2017 Dec;26(12):2232-2237. doi: 10.1002/pon.4452. Epub 2017 May 31.
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 2 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).
Fourth-year students (N = 236) were randomly assigned to the intervention or comparison group. The 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 7 nonverbal behaviors.
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).
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.
在肿瘤学领域对医学生进行不良消息通报（BBN）培训可能是改善患者护理的关键，因为许多医生在这一领域往往感到不舒服。鉴于文献中缺乏证据，本研究旨在通过两种教学策略来实证评估为学生准备肿瘤学中 BBN 任务的效果：一对一模拟患者（SP）培训和个人反馈（干预组）与小组 SP 培训和集体反馈（对照组）。
将四年级学生（N=236）随机分配到干预组或对照组。使用卡尔加里-剑桥 BBN 教学目标检查表分析 SP 录像采访，以评估 BBN 沟通表现；使用 Roter 互动分析系统对口头互动行为进行编码；以及对 7 种非言语行为进行编码。
干预组学生在培训后对访谈的整体评估（P<.001）以及对过程技能（P<.001）的评分均显著高于培训前；与对照组学生相比，干预组学生在访谈的整体评估（P<.001）和过程技能（P<.001）方面的评分也更高。
本研究支持个性化的 BBN 教学策略，并有助于努力寻找最佳方式来培训和接触更多的未来医生，以提高肿瘤学领域的沟通能力。
