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. 2011 Jul;1(2):121-4.
doi: 10.4103/2229-5151.84796.

Educating the delivery of bad news in medicine: Preceptorship versus simulation

Andrew P Jacques  1 , Eric J Adkins, Sheri Knepel, Creagh Boulger, Jessica Miller, David P Bahner
Affiliations

Educating the delivery of bad news in medicine: Preceptorship versus simulation

Andrew P Jacques et al. Int J Crit Illn Inj Sci. 2011 Jul.

Abstract

Simulation experiences have begun to replace traditional education models of teaching the skill of bad news delivery in medical education. The tiered apprenticeship model of medical education emphasizes experiential learning. Studies have described a lack of support in bad news delivery and inadequacy of training in this important clinical skill as well as poor familial comprehension and dissatisfaction on the part of physicians in training regarding the resident delivery of bad news. Many residency training programs lacked a formalized training curriculum in the delivery of bad news. Simulation teaching experiences may address these noted clinical deficits in the delivery of bad news to patients and their families. Unique experiences can be role-played with this educational technique to simulate perceived learner deficits. A variety of scenarios can be constructed within the framework of the simulation training method to address specific cultural and religious responses to bad news in the medical setting. Even potentially explosive and violent scenarios can be role-played in order to prepare physicians for these rare and difficult situations. While simulation experiences cannot supplant the model of positive, real-life clinical teaching in the delivery of bad news, simulation of clinical scenarios with scripting, self-reflection, and peer-to-peer feedback can be powerful educational tools. Simulation training can help to develop the skills needed to effectively and empathetically deliver bad news to patients and families in medical practice.

Keywords: Bad news delivery; end-of-life care; medical education; palliative care; simulation.

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Conflict of interest statement

Conflict of Interest: None declared.

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References

    1. Orlander JD, Fincke BG, Hermanns D, Johnson GA. Medical residents’ first clearly remembered experiences of giving bad news. J Gen Intern Med. 2002;17:825–31. - PMC - PubMed
    1. Kowalenko T, Walters BL, Khare RK, Compton S. Michigan College of Emergency Physicians Workplace Violence Task Force. Workplace Violence: A Survey of Emergency Physicians in the State of Michigan. Ann Emerg Med. 2005;46:142–7. - PubMed
    1. Orgel E, McCarter R, Jacobs S. A failing medical educational model: A self-assessment by physicians at all levels of training of ability and comfort to deliver bad news. J Palliat Med. 2010;13:677–83. - PubMed
    1. Deep KS, Griffith CH, Wilson JF. Communication and decision making about life-sustaining treatment: Examining the experiences of resident physicians and seriously-ill hospitalized patients. J Gen Intern Med. 2008;23:1877–82. - PMC - PubMed
    1. Minor S, Schroder C, Heyland D. Using the intensive care unit to teach end-of-life skills to rotating junior residents. Am J Surg. 2009;197:814–9. - PubMed