Karam Vanda Yazbeck, Barakat Hanane, Aouad Marie, Harris Ilene, Park Yoon Soo, Youssef Nazih, Boulet John Jack, Tekian Ara
Lebanese American University School of Medicine, P.O. Box: 36, Beirut, Lebanon.
American University of Beirut Medical Center, Beirut, Lebanon.
BMC Anesthesiol. 2017 Jun 14;17(1):77. doi: 10.1186/s12871-017-0374-7.
Breaking bad news (BBN) to patients and their relatives is a complex and stressful task. The ideal structure, training methods and assessment instruments best used to teach and assess BBN for anesthesiology residents remain unclear. The purpose of this study is to evaluate the effectiveness of an education intervention for BBN based on immersive experiences with a high fidelity simulator and role-play with standardized patients (SPs). A secondary purpose is to gather validity evidence to support the use of a GRIEV_ING instrument to assess BBN skills.
The communication skills for BBN of 16 residents were assessed via videotaped SP encounters at baseline and immediately post-intervention. Residents' perceptions about their ability and comfort for BBN were collected using pre and post workshop surveys.
Posttest scores were significantly higher than the pretest scores for the GRIEV_ING checklist, as well as on the communication global rating. The GRIEV_ING checklist had acceptable inter-rater and internal-consistency reliabilities. Performance was not related to years of training, or previous BBN experience.
Anesthesiology residents' communication skills when BBN in relation to a critical incident may be improved with educational interventions based on immersive experiences with a high fidelity simulator and role-play with SPs.
向患者及其亲属传达坏消息是一项复杂且压力巨大的任务。用于麻醉科住院医师教学和评估传达坏消息的理想结构、培训方法及评估工具仍不明确。本研究的目的是评估基于高保真模拟器的沉浸式体验和标准化病人角色扮演的传达坏消息教育干预的有效性。第二个目的是收集效度证据，以支持使用GRIEV_ING工具评估传达坏消息的技能。
通过在基线和干预后立即对标准化病人的录像访谈，评估16名住院医师传达坏消息的沟通技巧。使用工作坊前后的调查问卷收集住院医师对自己传达坏消息能力和舒适度的看法。
GRIEV_ING清单的后测分数以及沟通总体评分显著高于前测分数。GRIEV_ING清单具有可接受的评分者间信度和内部一致性信度。表现与培训年限或以前传达坏消息的经验无关。
基于高保真模拟器的沉浸式体验和与标准化病人的角色扮演的教育干预，可能会提高麻醉科住院医师在与危急事件相关的传达坏消息时的沟通技巧。
