4.0 Article

Training first-year medical residents to break bad news using healthcare role-play and trainees as simulated patients: Experience of the ADIAMED program from Lille University School of Medicine

Journal

REVUE DE MEDECINE INTERNE
Volume 44, Issue 12, Pages 632-640

Publisher

ELSEVIER FRANCE-EDITIONS SCIENTIFIQUES MEDICALES ELSEVIER
DOI: 10.1016/j.revmed.2023.10.451

Keywords

Breaking bad news; Role-play; Simulated patients; Healthcare simulation; Educational assessment; Medical residency

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Healthcare role-play is an interesting technique for training doctors to deliver bad news. Placing doctors in the roles of patients or relatives encourages reflection.
Introduction. - Several studies suggest the relevance of healthcare simulation to prepare future doctors to deliver bad news. A such, we designed a role-play workshop to train first-year residents enrolled in Lille University School of Medicine to break bad news. The objective of this work is to report on our experience of this training and to assess its educational value through its capacity to satisfy residents' expectations, to induce a feeling of ease towards bad news disclosure, and to change trainees' preconceptions regarding these situations. Methods. - The training consisted of a 45-minute heuristic reflective activity, aimed at identifying residents' preconceptions regarding bad news disclosure, followed by 4 30-min role-plays in which they played the parts of the physician, the patient and/or their relatives. Trainees were asked to answer 2 questionnaires (pre- and post-training), exploring previous experiences, preconceived ideas regarding bad news disclosure and workshop satisfaction. Results. - Almost all residents felt very satisfied with the workshop, which they regarded as formative (91%) and not too stressful (89%). The majority felt more capable (53% vs. 83%) and more comfortable (27% vs. 62%) to deliver bad news, especially regarding finding the right words (12% vs. 22%). Trainees tended to overestimate their skills before the workshop and lowered their assessment of their performance after attending the training, especially when they played the role of a patient in the simulation. Conclusion. - Healthcare role-play seems an interesting technique for training to breaking bad news. Placing residents in the role of patients or relatives is an active approach that encourages reflexivity. (c) 2023 Socie ' te ' Nationale Franc, aise de Me ' decine Interne (SNFMI). Published by Elsevier Masson SAS. All rights reserved.

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