Class Room to Real Life: Medical Students Perception and Barriers regarding Breaking Bad News (original) (raw)
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International Journal of Medical Education, 2014
The aim of this study was to analyse the psychometric properties of the short version of the Calgary Cambridge Guides and to decide whether it can be recommended for use in the assessment of communications skills in young undergraduate medical students. Methods: Using a translated version of the Guide, 30 members from the Department of General Practice rated 5 videotaped encounters between students and simulated patients twice. Item analysis should detect possible floor and/or ceiling effects. The construct validity was investigated using exploratory factor analysis. Intra-rater reliability was measured in an interval of 3 months, inter-rater reliability was assessed by the intraclass correlation coefficient. Results: The score distribution of the items showed no ceiling or floor effects. Four of the five factors extracted from the factor analysis represented important constructs of doctor-patient communication The ratings for the first and second round of assessing the videos correlated at 0.75 (p < 0.0001). Intraclass correlation coefficients for each item ranged were moderate and ranged from 0.05 to 0.57. Conclusions: Reasonable score distributions of most items without ceiling or floor effects as well as a good test-retest reliability and construct validity recommend the C-CG as an instrument for assessing communication skills in undergraduate medical students. Some deficiencies in inter-rater reliability are a clear indication that raters need a thorough instruction before using the C-CG.
Training of medical interns in breaking bad news using DISHA protocols
Background: Breaking bad news is an un pleasant task and doing it at the wrong time or at wrong place and in the wrong manner can be even worse. Moreover, this process is just as hard for the person breaking the bad news as it is for the person receiving it. Yet this important Communication Skill is seldom taught to us in our training days as an Intern. Aim: To orient the medical Interns to the concept of " Bad News " and then training them in " Breaking Bad News " in a scientific and socially acceptable manner by using a new indigenous protocol called " DISHA ". Materials and Methods: The concept of Breaking Bad News (BBN) was first explained to the Interns. Questionnaire was used to know if they felt comfortable in BBN. They were explained the protocol for BBN by an experienced faculty with help of scenario of a patient of cancer cervix. Questionnaire was used to assess if they had understood the protocol and whether they felt comfortable in BBN post intervention. Responses from the interns were obtained on the Likert Scale of 1-5; where 1-Strongly Disagree, and 5-Strongly Agree. Student's paired-t test was used to find and compare the mean scores in pre and post intervention phase. Results: Total 76 medical interns participated in this study, out of which 31 were females and 45 were males. Mean age of participants was 22.75 years. Overall the mean score changed from 2.20±.80 to 3.70±.57 (p<0.001). In female participants, the over the mean score changed from 2.26±.93 to 3.61±.72 (p<0.001). In male participants, the over the mean score changed from 2.16±.71 to 3.76±.57 (p<0.001). Conclusion: The change in mean score of participants in response to pre intervention as well as post intervention questionnaire pertaining to BBN using DISHA protocol was significant (p<0.001); thus emphasizing the utility of this educational intervention.
Communication Apprehension Among Health Students
2021
Objective. To determine the levels of communication apprehension (CA) experienced by health students and compare them according to sex, age range, course, and academic year. Method. A cross-sectional study was conducted at a Brazilian university from December 2019 to May 2020 with dentistry, pharmacy, medicine, and nursing students, recruited by convenience sampling. The students were invited to answer a survey consisting of two sections: general characteristic and the Personal Report of Communication Apprehension (PRCA-24). Univariate and bivariate analyses were conducted. Results. A total of 644 health students answered the survey, of whom 25.5% were classified as having high communication apprehension. Male participants had significantly lower PRCA-24 scores than females. No significant differences were found between PRCA-24 scores by age category or academic year. Medical students had significantly lower mean PRCA-24 scores than pharmacy students. Conclusion. The prevalence of h...
Psychiatry Investigation
Objective The conduct of a medical interview is a challenging skill, even for the most qualified physicians. Since a training is needed to acquire the necessary skills to conduct an interview with a patient, we compared role-play with standardized patients (SP) training and a conventional lecture for the acquisition of communications skills in undergraduate medical students.Methods An entire promotion of third year undergraduate medical students, who never received any lessons about communications skills, were randomized into 4 arms: 1) SP 2 months before the testing of medical communications skills (SP); 2) conventional lecture 2 months before the testing (CL); 3) two control groups (CG) without any intervention, tested either at the beginning of the study or two months later. Students were blindly assessed by trained physicians with a modified 17-items Calgary-Cambridge scale.Results 388 students (98.7%) participated. SP performed better than CL, with significant statistical diffe...
Journal of Education and Health Promotion, 2020
BACKGROUND: Communication apprehension (CA) is the fear or anxiety about communicating. This study was designed to investigate the CA and its related factors in the medical students at Rafsanjan University of Medical Sciences (RUMS). MATERIALS AND METHODS: In this cross-sectional study, personal report of CA (PRCA-24) was administered to 340 medical and paramedical students to measure anxiety in four domains of large groups, small groups, public speaking, and dyadic interaction. Pearson's correlation and linear regression analysis were used to investigate the relationship between CA and the variables of birth order, number of siblings, and university entrance score. Data were analyzed using descriptive and inferential statistics (Chi-square and Kruskal-Wallis Test). RESULTS: CA in the dimension of public speaking was higher than the other dimensions. Evaluation of the economic stability and its relationship to CA indicated a significant difference among all the domains of the PRCA-24. There was a significant relationship between the scores of CA and the number of siblings (P = 0.001). Linear regression and Pearson's correlation tests indicated a significant correlation between the variables of birth order, number of siblings, and university entrance score. The correlation between the CA with dimensions of group discussion, interpersonal, speaking, and meeting was weak but significant (P < 0.01). CONCLUSION: Without communication, the materialization and development of the human community are not possible. This aspect is more evident and crucial in the healthcare industry. Based on the results of this study, the medical and paramedical students at RUMS have a medium-to-high level of CA. Therefore, it is of utmost importance to detect students with high CA to prevent further communication problems after graduation.