The Effect of Guided group Reflection on the Ability and Convenience of Breaking Bad News in Pre-hospital Emergency Staff (original) (raw)
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Evaluation of emergency medical services staff knowledge in breaking bad news to patients
Journal of International Medical Research
Objective The aim of the study was to investigate knowledge of breaking bad news (BBN) among medical personnel in the emergency medical services (EMS). Methods A cross-sectional survey was conducted of 148 individuals employed in EMS. An interview was conducted using a structured questionnaire. Results Of study participants, 89.2% were not aware of any formal BBN procedure and 58.1% had not participated in any form of training. Compared with males, females were more likely to report that dealing with the emotional state of the family or the patient was the most difficult aspect of BBN. Only a few participants were aware of the SPIKES protocol for BBN, and none knew what the acronym meant. Sex, educational level, occupation, work experience and workplace were not associated with knowledge of BBN procedures. Conclusions Knowledge of BBN in both male and female EMS staff was insufficient. EMS personnel held different opinions about the method of BBN. Even staff who have participated in...
The Effect of Reflection on Nurse-Patient Communication Skills in Emergency Medical Centers
Journal of Caring Sciences, 2019
Introduction: Reflection is formed through deep reflection on the event or a certain clinical position. The aim of this study was to determine the effect of reflection on nurse-patient communication skills of nurses working in emergency departments. Methods: This interventional study was conducted on intervention and control groups and with a pretest-posttest design. 142 nurses working in the emergency departments of hospitals affiliated to Golestan University of Medical Sciences were enrolled in the study in 2015, and randomly divided into two groups. During eight weeks of the study, the intervention group was asked to write their clinical experiences with regard to communication issues with their patients. Before the intervention, the communication skills of both groups were compared using a questionnaire. Data analysis was performed, using independent t-test, paired t-test, Mann-Whitney and Wilcoxon tests. Results: Of the 142 nurses, 122 nurses had full participation. In the inte...
Indian Journal of Forensic Medicine & Toxicology, 2021
Introduction:'Breaking Bad News' (BBN) in the scenario of poor prognosis or death is considered to be one of the most stressful aspects of the duties of a Healthcare professional. In the recent years, the subject of BBN has gained traction among healthcare professionals and psychologist leading to the creation of some comprehensive models to train professionals. Emergency Medical Professionals are among the likeliest to encounter BBN situations. Hence it is imperative that they be formally trained to deal with patients and their families effectively Objective: To assess the training needs regarding 'Breaking Bad News' (BBN); amongst Emergency Medical Services (EMS) Professionals. Methodology: The study was conducted amongst 150 Emergency Medical Professionals in Pune, India. A previously tested and validated questionnaire developed by Rasmus etal in June 2020 was utilized for the study. Questionnaire was administered to the respondents through online mode after obtaining informed consent. Responding to all questions was mandatory. The respondents were given one day to fill the questionnaire. Any queries pertaining to questionnaire were clarified during data collection. Discussion: The present study was done to assess the baseline awareness of EMS professionals about BBN and to devise a customized training program for them. Unfortunately, majority of the respondents were not even aware that BBN is a separate subject having specific procedures and protocols followed globally. The lack of training instils fear of facing such situations and adversely affects the mental health of EMS professionals. This can be corrected by utilizing tools like simulation and role play to provide adequate exposure to EMS professionals in a safe environment. Conclusion: The findings of the study point towards an emergent need of formal practical training on this crucial yet ignored aspect of the health care professionals' duties. Comparative Studies can be conducted in the future to assess the effectiveness of this training program.
Self-assessment of residents in breaking bad news; skills and barriers
BMC Medical Education
Introduction Breaking bad news (BBN) is inevitable in medicine and is one of the most important and difficult professional tasks of physicians. The main aims of this study are to evaluate residents’ practice of BBN and identify perceived barriers to its implementation. Methods In this cross-sectional study in 2021, 240 residents from medical, surgical, and emergency medicine departments completed the demographic questionnaire, the Persian SPIKES questionnaire (P-SPIKES), and the researchers-made questionnaire of Barriers to Breaking Bad News (BBBN). In addition, they were asked about their previous experience, previous training, and their perceived level of competence in BBN. Results 46.5% and 36.84% of residents rated their perceived competence in BBN and managing the patient’s emotions during BBN as good or very good, respectively. The most difficult aspects of BBN for residents were expressing upsetting information (78.1%) and not disappointing the patient while being honest (58....
BMC anesthesiology, 2017
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 i...
A cross sectional study on awareness regarding breaking bad news among medical interns
Al Ameen Journal of Medical Sciences, 2017
Background: Bad news is a situation where there is a feeling of no hope or a threat to person's mental or physical wellbeing. Disclosing bad news needs appropriate communication skills, resulting in a satisfied doctor-patient relationship. Most of the medical graduates acquire this skill through observation and not through specific training. Objectives: To study awareness regarding breaking bad news among medical interns. Methods: This cross sectional study was conducted among complete batch of 112 medical interns, attached to a tertiary care hospital between Jan-June 2016. A predesigned, pretested, semi- structured questionnaire was used. Results: Only 58% of the participants were aware about what is a bad news but 80% were not aware about how to break a bad news. Half of them felt no need to conduct training. Over >3/4th agreed that doctors were primary deliverers and it can cause stress, anxiety in the recipient. 95% felt that it can alter patients view if conducted improp...
BMC Health Services Research, 2021
Background Work stress and compassion fatigue are prevalent among healthcare staff and their negative effects on staff well-being and patient care are well-known. This paper reports on the implementation and evaluation of Schwartz Rounds® (Rounds) in UK healthcare organizations, predominantly part of the National Health Service (NHS). Rounds are one-hour, typically monthly, multidisciplinary forums during which clinical and nonclinical healthcare staff discuss the emotional and social demands of delivering patient care. The purpose of this research was to evaluate the effectiveness of Rounds attendance on the psychological distress, work engagement, compassion and self-reflection of healthcare staff. Methods We used a pre-post control design to assess the effect of Rounds attendance across 10 UK healthcare organizations. This design was most appropriate given the voluntary nature of Rounds and ensured the study had ecological validity. Self-reported data were collected from attender...
Efficacy of a Short Role-Play Training on Breaking Bad News in the Emergency Department
Western Journal of Emergency Medicine, 2019
Breaking bad news (BBN) in the emergency department (ED) represents a challenging and stressful situation for physicians. Many medical students and residents feel stressed and uncomfortable with such situations because of insufficient training. Our randomized controlled study aimed to assess the efficacy of a four-hour BBN simulation-based training on perceived selfefficacy, the BBN process, and communication skills. Methods: Medical students and residents were randomized into a 160-hour ED clinical rotation without a formal BBN curriculum (control group [CG], n = 31) or a 156-hour ED clinical rotation and a four-hour BBN simulation-based training (training group [TG], n = 37). Both groups were assessed twice: once at the beginning of the rotation (pre-test) and again four weeks later. Assessments included a BBN evaluation via a simulation with two actors playing family members and the completion of a questionnaire on self-efficacy. Two blinded raters assessed the BBN process with the SPIKES (a delivery protocol for delivering bad news) competence form and communication skills with the modified BBN Assessment Schedule. Results: Group-by-time effects adjusted by study year revealed a significant improvement in TG as compared with CG on self-efficacy (P < 0.001), the BBN process (P < 0.001), and communication skills (P < 0.001). TG showed a significant gain regarding the BBN process (+33.3%, P < 0.001). After the training, students with limited clinical experience prior to the rotation showed BBN performance skills equal to that of students in the CG who had greater clinical experience. Conclusion: A short BBN simulation-based training can be added to standard clinical rotations. It has the potential to significantly improve self-efficacy, the BBN process, and communication skills.
Interventions for critical incident stress in emergency medical services: a qualitative study
Stress and Health, 2009
Background: Controversy over the use of Critical Incident Stress Debriefing leaves Emergency Medical Services (EMS) organizations with little direction in preventing sequelae of Critical Incident Stress (CIS) in their employees. Objective: To explore and describe Emergency Medical Technicians' (EMTs) experiences of critical incidents and views about potential interventions, in order to facilitate the development of interventions that take into account EMS culture. Methods: We interviewed 60 EMT practitioners and supervisors, and examined interview transcripts using ethnographic content analysis. Results: Participants experience a brief time-out and early emotional support from supervisors and peers as important in preventing sequelae of CIS. Differences between supervisor and peer support as well as barriers to support are illustrated, and ways to address them through education are proposed. An organizational culture that stigmatizes emotional vulnerability underlies many of the barriers. Conclusions: EMT practitioners want emotional support in their workplace soon after a critical incident, and would welcome interventions that enhance this. Educating supervisors and frontline practitioners to recognize and respond to critical incidents is acceptable to them and perceived as important, along with simple interventions such as a brief time-out. Directly addressing the issue of stigma in EMS culture is critical to developing appropriate interventions.
Colombia Médica, 2009
Introduction: Breaking bad news is one of a physician's most difficult duties. There are several studies related to the patient's needs, but few reflect on the doctors' experience. Materials and method: A descriptive, cross-sectional research was carried out to study issues related to the process of delivering bad news which might act as barriers and facilitating skills from the doctor's point of view. These issues were identified through a self-administered survey. Results: Participant doctors use different strategies to communicate bad news to their patients. Examples of these strategies are: to be familiar with the patients' medical history, to ensure that there is enough time, to know the patient's caregivers and/ or relatives, to determine the patient's level of knowledge about his/her condition, to use non-technical words, to give information in small pieces, to assess the patient's understanding, to devise a joint action plan, among others. Conclusion: The communication barriers that were identified focused on the emotional issues of the communication process, particularly those related to the recognition of own emotions, and the limited training about communication strategies available to doctors. Consequently, there is a need to implement training programs that provide doctors with tools to facilitate the bad news communication process.