Teaching communication skills in health care: Three educational approaches

Teaching communication skills in health care: Three educational approaches

Patient Education and Counseling 34 (1998) S43–S55 Workshops / symposia 1 workshop TEACHING COMMUNICATION SKILLS IN HEALTH CARE: THREE EDUCATIONAL A...

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Patient Education and Counseling 34 (1998) S43–S55

Workshops / symposia 1


Walter F. Baile, M.D. MD Anderson Cancer Center, 1515 Holcombe Blvd, Box 100, Houston, Texas USA 77030.Phone: 713 -792 -7546, Fax: 713 -794 -4999, Email: [email protected] utmdacc.mda.uth.tmc.edu This symposium will present three educational approaches to teaching communication skills to physicians, medical students nurses and allied health personnel. Teaching medical students how to break bad news Robert C. Buckman, M.D. Bad news can be defined as ‘‘any information that significantly and adversely affects a patients future.’’ Despite the fact that in medical practice this is a frequent task of patient care, formal education in how to break bad news for medical professionals is usually lacking during post-graduate education. Observational studies have shown that clinicians often use ‘‘distancing tactics’’ by avoiding these situations entirely, attempting to cushion the impact of the bad news with false reassurance or changing the topic when the patient asks difficult questions about the prognosis. This presentation will present a protocol for breaking bad news and report on the results of five years of teaching a course using this protocol to University of Toronto medical students. The course incorporates a video presentation, a discussion period and small group teaching followed by role-play with standardized patients. Data incorporated in 914 pre-course and 503 post-course questionnaires was evaluated. The number of students who felt confidence in breaking bad news increased from 22% to 74%. The number of students who felt that they could develop a strategy for breaking bad news increased from 49% to 92%. Most students found the course enjoyable and that it increased their confidence in discussing bad news information with patients and families. An interactive CD-ROM for teaching communication skills to clinicians Barbara M. Korsch, M.D., Robert C. Buckman, M.D., Walter F. Baile, M.D., Suzanne Kurtz, PhD

The authors will present a demo of an interactive CDROM developed to assist health care professionals improve their communication skills with patients. The CD-ROM is broken down into three main sections: 1) the basic communication skills necessary to achieve a rapport with a patient and elicit the patient’s concerns; 2) advanced skills such as addressing patient’s feelings, uncovering hidden problems, addressing patient’s anger and referring a patient for mental health treatment; 3) specific tasks such as breaking bad news and interviewing children and their parents. The teaching program also includes a module on the essentials of genetic counselling. The teaching format is based upon filmed presentations of clinical encounters which are incorporated into the CD-ROM. Two unique features of the CD-ROM are the inclusion of ‘‘decision points’’ which allow the user to choose among several different responses to the clinical problem presented. The user is then able to see a portrayal of his response acted out and if desirable to select different choices. A second feature is a clinical tutor who occasionally appears on the screen to guide the learner through the program. The CD-ROM is designed to be PC compatible and totally user-friendly. The content is designed to be relevant to physicians in practice, nurses, medical students and allied health personnel. Communicating with cancer patients: Format and outcomes of workshops for oncologists and oncology fellows Walter F. Baile, M.D., Estela Beale, M.D., Mickey Baumbaugh, M.A., Gary Glober, M.D., Andrzej Kudelka, M.D., Renato Lenzi, M.D., Eric G. Myers, M.A., Debra Sivesind, CNS The authors conducted five educational workshops for seventy oncologists and oncology fellows on the following topics: Communicating with cancer patients, breaking bad news, managing problem situations (e.g. discussing patient resuscitation wishes) and Identifying and managing sources of stress and burnout in clinical care. The workshops were ‘‘learning-centered’’ (i.e. participants selected the workshop agenda topics) and used a combination of didactic approaches. These included simulated

0738-3991 / 98 / $19.00  1998 Elsevier Science Ireland Ltd. All rights reserved. PII S0738-3991( 98 )00057-3