Schmitz Felix Michael, Buzzi Ann-Lea, Felber Sibylle Jeanine, Zambrano Sofia Carolina, Hitzblech Tanja, Schnabel Kai Philipp, Eychmüller Steffen, Guttormsen Sissel
Institute for Medical Education, University of Bern, Bern, 3010, Switzerland.
Institute for Medical Education, University of Bern, Mittelstrasse 43, Bern, 3012, Switzerland.
BMC Med Educ. 2025 Jul 1;25(1):979. doi: 10.1186/s12909-025-07178-8.
Caring for dying individuals is a key aspect of many clinical and medical practices. However, training and reflection opportunities on conversations between healthcare professionals, dying patients, and caregivers are limited. To address this gap, we developed a blended-learning approach focusing on effective communication about approaching death, termed Talking About Dying (TAD). This study aimed to evaluate the impact of this approach on pre- and postgraduate medical learners' knowledge, anxiety, self-efficacy, and skills related to TAD.
A pre-test post-test trial with n = 12 medical students and n = 11 nursing professionals was applied. Data were collected at three time points: (1) at baseline (pre-intervention) (2), after a 45-minute online TAD module (post-intervention I), and (3) after a 90-minute onsite workshop with experts (post-intervention II). Knowledge was tested with self-developed multiple-choice questions, while anxiety when discussing death and self-efficacy were assessed using published questionnaires, i.e., the 7-item Thanatophobia Scale and a 1-item scale according to Bandura. Participants demonstrated their TAD-related skills in encounters with simulated patients, which were scored by trained assessors using a self-developed scale. The TAD online module (intervention I) included text and video demonstrations with critical hints, while the onsite workshop (intervention II) involved group reflection, discussion, and role-play to deepen understanding.
Participants demonstrated increased knowledge, reduced thanatophobia (amongst medical students but not nursing professionals), and enhanced self-efficacy and skills following both interventions, with these effects being both statistically and practically significant.
Combining an online module with an in-person workshop can meaningfully enhance learning outcomes across cognitive, affective, and behavioural dimensions related to TAD conversations for both medical students and professional nurses, though changes in the affective dimensions were observed only in students. We recommend integrating this method into medical and nursing education.
Not applicable.
照顾临终患者是许多临床和医疗实践的关键环节。然而，医疗保健专业人员、临终患者及其护理人员之间对话的培训和反思机会有限。为了弥补这一差距，我们开发了一种混合式学习方法，重点是就接近死亡的话题进行有效沟通，称为“谈论死亡”（TAD）。本研究旨在评估该方法对医学研究生和本科生在与TAD相关的知识、焦虑、自我效能感和技能方面的影响。
对12名医学生和11名护理专业人员进行了一项前后测试验。在三个时间点收集数据：（1）基线（干预前）；（2）在45分钟的TAD在线模块学习后（干预后I）；（3）在与专家进行90分钟的现场研讨会后（干预后II）。通过自行编制的多项选择题测试知识，使用已发表的问卷评估讨论死亡时的焦虑和自我效能感，即7项死亡恐惧量表和根据班杜拉编制的1项量表。参与者在与模拟患者的接触中展示他们与TAD相关的技能，由经过培训的评估人员使用自行编制的量表进行评分。TAD在线模块（干预I）包括带有关键提示的文本和视频演示，而现场研讨会（干预II）包括小组反思、讨论和角色扮演，以加深理解。
参与者在两次干预后均表现出知识增加、死亡恐惧减少（医学生中是这样，但护理专业人员中并非如此）、自我效能感和技能增强，这些效果在统计学和实际意义上均显著。
将在线模块与现场研讨会相结合，可以显著提高医学生和专业护士在与TAD对话相关的认知、情感和行为维度上的学习成果，不过情感维度的变化仅在学生中观察到。我们建议将这种方法纳入医学和护理教育。
不适用。
