Evaluation of Medical internship students' communication skills about breaking bad news
DOI:
https://doi.org/10.33448/rsd-v11i16.38198Keywords:
Medical Education; Communication; Physician-Patient Relations; Clinical competence.Abstract
This study aims to assess the skills of medical students in communicating bad news. Cross-sectional, analytical and observational study using a practical assessment checklist in the Objective Structured Clinical Examination (OSCE) style of medical students based on the SPIKES protocol containing 12 different items. A total of 172 checklists were evaluated, 61 (35.5%) from the 1st semester of the internship, 59 (34.3%) from the 2nd semester and 52 (30.2%) from the third semester. Of the total, 56.97% were female. There was no statistical difference between sex and periods evaluated (p>0.05). The mean number of correct answers in the 1st semester of the internship was 8.21 ±2.60, that of the 2nd semester was 7.13 ±2.51 and that of the 3rd semester was 9.98 ±1.72. Medical interns performed well on difficult news communication skills, however, the evaluation semester proved to be a factor of improvement in performance, evidencing the importance of training this skill.
References
Amorim, C. B. et al. (2021). Communication of difficult news in basic attention/Comunicação de notícias difíceis na atenção básica. Revista de Pesquisa: Cuidado é Fundamental [online], Rio de Janeiro, 13, 34-40. https://doi.org/10.9789/2175-5361.rpcfo.v13.7138.
Baile, W.F.; et al. (2000). Spikes-A six-step protocol for delivering bad news: application to the patient with cancer. Oncologist. 5(4), 302-11,. doi: 10.1634/theoncologist.5-4-302.
Balzan, N.C.; Wandercil, M. (2019). Formando médicos: a qualidade em questão. Avaliação: Revista da Avaliação da Educação Superior (Campinas), 24(3), 744-765, doi: 10.1590/s1414-40772019000300010.
Camargo, N. C.; et al. (2019). Ensino de comunicação de más notícias: revisão sistemática. Rev. Bioét.27(2), 326-340. doi:10.1590/1983-80422019272317.
Cassiano, M.S.; Passeri, S. M.R.; Lutaif, N. A. (2021). Realidade ou simulação? Análise do desempenho de estudantes de Medicina em avaliações práticas distintas. Revista Brasileira de Educação Médica. 45(1), e008. doi:10.1590/1981-5271v45.1-20200173.
Cavalcante, F. P. G., Cestari, V. R. F., & Cavalcante, A. (2022). Mapeamento dos protocolos disponíveis para comunicação de más notícias em saúde: protocolo de revisão de escopo. Research, Society and Development, 11(12), e418111234608-e418111234608.
Coutinho, F., Ramessur, A. (2016). An overview of teaching communication of bad news in medical school: should a lecture be adequate to address the topic? Acta Médica Portuguesa, 29(12), 826-831.
Feitosa Junior, D.J.S. et al. (2018). Knowledge of medical students about the SPIKES protocol. PRMJ. 2(1), e06.. doi: 10.4322/prmj.2018.006.
Franco, S. C. et al. (2019). Análises pelos discentes de uma escola médica das atividades de integração ensino-serviço na graduação. REAS. 33, e921. doi: 10.25248/reas.e921.2019
Freiberger, M.H., Carvalho, D., Bonamigo, E.L. (2019). Comunicação de más notícias a pacientes na perspectiva de estudantes de medicina. Revista Bioética, Brasília, DF, 27(2), 318-325, https://doi.org/10.1590/1983-80422019272316.
Giemsa, P. et al. (2020). What works best in a general practice specific OSCE for medical students: Mini-CEX or content-related checklists? Med Teach. 42(5), 578-584, doi: 10.1080/0142159X.2020.1721449.
Gorniewicz, J. et al. (2017). Breaking bad news to patients with cancer: A randomized control trial of a brief communication skills training module incorporating the stories and preferences of actual patients. Patient Educ Couns. 100(4), 655-666.. doi: 10.1016/j.pec.2016.11.008.
Johnson, J., Panagioti, M. (2018). Interventions to Improve the Breaking of Bad or Difficult News by Physicians, Medical Students, and Interns/Residents: A Systematic Review and Meta-Analysis. Acad Med. 93(9), 1400-1412. doi: 10.1097/ACM.0000000000002308.
Karnieli-Miller, O., et al. (2021). The associations between reflective ability and communication skills among medical students. Patient Educ Couns. 104(1), 92-98. doi: 10.1016/j.pec.2020.06.028.
Lee, H.R., Yi, S.Y. (2013). Delivering bad news to a patient: a survey of residents and fellows on attitude and awareness. Korean J Med Educ. 25(4), 317-25,. doi: 10.3946/kjme.2013.25.4.317.
Lemos, L.F.S. & Cunha, A.C.B. (2015). Morte na maternidade: como profissionais de saúde lidam com a perda. Psicologia em Estudo, 20(1). Departamento de Psicologia -Universidade Estadual de Maringá.
Liénard, A., 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(2), 171-7,. doi: 10.1038/sj.bjc.6605749.
Lobo, R. D.; et al. (2022). Avaliação do efeito Hawthorne durante a manipulação do cateter venoso central. Revista da Escola de Enfermagem da USP, 56, e20220125-e20220125,.
Marschollek, P. et al. (2019). Oncologists and Breaking Bad News-From the Informed Patients' Point of View. The Evaluation of the SPIKES Protocol Implementation. Cancer Educ. 34(2), 375-380,. doi: 10.1007/s13187-017-1315-3.
Melo, C.F., et al. (2022). Comunicação de más notícias no trabalho médico: um olhar do paciente com prognóstico reservado. Trabalho, Educação e Saúde, 20, p. 14-14.
Nonino, A., Magalhães, S. G., Falcão, D. P. Treinamento médico para comunicação de más notícias: revisão da literatura. Revista Brasileira de Educação Médica. 36(2), 228-233, 2012. doi:10.1590/S0100-55022012000400011.
Ortega, P., Park, Y.S., Girotti, J. A. (2017). Evaluation of a Medical Spanish Elective for Senior Medical Students: Improving Outcomes through OSCE Assessments. Med Sci Educ. 27(2), 329-337. doi: 10.1007/s40670-017-0405-5
Pazinatto, M. M. (2019). A relação médico-paciente na perspectiva da Recomendação CFM 1/2016. Revista Bioética, Brasília, DF, 27(2), 234-243. https://doi.org/10.1590/1983-80422019272305.
Pereira A. S. et al. (2018). Metodologia da pesquisa científica. [free e-book]. Santa Maria/RS. Ed. UAB/NTE/UFSM.
Ramaswamy, R., et al. (2014). Communication skills curriculum for foreign medical graduates in an internal medicine residency program. Journal of the American Geriatrics Society, 62(11), 2153-2158.
Scheffer, M.C., Cassenote, A.J.F. (2013). A feminização da medicina no Brasil. Rev. Bioét. 21(2), 268-277. doi: 10.1590/S1983-80422013000200010.
Servotte, J.C., et al. (2019). Efficacy of a Short Role-Play Training on Breaking Bad News in the Emergency Department. West J Emerg Med. 20(6), 893-902. doi: 10.5811/westjem.2019.8.43441.
Setubal, M.S.V., et al. (2018). Aprimoramento das habilidades de residentes em perinatologia para comunicar más notícias: um estudo de intervenção randomizado. Revista Brasileira de Ginecologia e Obstetrícia, 40, 137-146.
Silva, E. E. G., Rodriguez, G. C., da Silveira, G. B., dos Santos Laguna, T. F., Cella, M. L. S. G., Rangel, R. F., & Kruel, C. S. (2021). Percepção dos profissionais da saúde acerca da comunicação de más notícias e óbitos no contexto perinatal. Research, Society and Development, 10(5), e43510515101-e43510515101.
Sombra Neto, Luís L., et al. (2017). Habilidade de comunicação da má notícia: o estudante de medicina está preparado? Revista Brasileira de Educação Médica, Brasília, DF, 41(2), 260-268. https://doi.org/10.1590/1981-52712015v41n2rb20160063.
Souza, Y.V., et al. (2020). Percepção de pacientes sobre sua relação com médicos. Revista Bioética, Brasília, DF, 28(2), 332-343, 2020. https://doi.org/10.1590/1983-80422020282395.
Studer, R. K.; Danuser, B.; Gomez, P. (2017). Physicians' psychophysiological stress reaction in medical communication of bad news: A critical literature review Int J Psychophysiol. 120, 14-22. doi: 10.1016/j.ijpsycho.2017.06.006.
Wouda, J. C.; Van de Wiel, H. B. (2012). The communication competency of medical students, residents and consultants. Patient Educ Couns. 86 (1), 57-62,. doi: 10.1016/j.pec.2011.03.011.
Tulsky, J.A., et al. (2017). A Research Agenda for Communication Between Health Care Professionals and Patients Living With Serious Illness. AMA Intern Med. 177(9), 1361-1366. doi: 10.1001/jamainternmed.2017.2005.
Van de Graaf, F., W., Lange, J. F. (2019). Hawthorne Effect Should Be Controlled for in Quality Control Studies-Reply. JAMA Surg. 154(10), 978,. doi: 10.1001/jamasurg.2019.2166.
Van Weel-Baumgarten, E.M. et al. (2012). Teaching and training in breaking bad news at the Dutch medical schools: a comparison. Medical teacher, 34(5), 373-381.
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