Delivering bad or difficult news. An innovative simulation-based education approach to prepare interdisciplinary fellowships

ABSTRACT

Background:

There is limited data on the effectiveness of training interventions to improve the delivery of bad news.

Methods:

This preliminary research included pre–post assessments and an open-ended survey to evaluate the effectiveness and perceived value of training on delivering bad news for 26 first- and second-year fellows from five adult and pediatric fellowship programs.

Results:

There was a significant increase in faculty assessment scores (34.5 vs. 41.0, respectively, Z = −3.661, p < 0.001) and Standardized Patient (SP) assessment scores (37.5 vs .44.5, respectively, Z = −2.244, p = 0.025). Fellows valued having a standard framework to aid in the delivery of bad news; receiving targeted feedback and having the opportunity to apply their skills in a subsequent case.

Conclusions:

A one-hour, four-phase lesson plan that includes an individualized training approach and simulation do-overs can be effective and valuable for preparing fellows to deliver bad news.

KEYWORDS:

• Communication programs
• truth disclosure
• patient simulation

Disclosure statement

No potential conflict of interest was reported by the author(s).

Ethics Disclosure

Weill Cornell Medicine IRB approved this research and determined this educational protocol met the exempt requirements; protocol 20-01021258, Feb 10, 2020.

Data Availability

Data are available upon reasonable request by contacting the corresponding author.

Additional information

Funding

This work was supported by NewYork Presbyterian Hospital Patient Experience Group.

Notes on contributors

Timothy C. Clapper

Timothy C. Clapper, PhD is Associate Professor of Teaching in Pediatrics at Weill Cornell Medical College.

Taylor B. Sewell

Taylor B. Sewell, MD, MBA, FAAP is an Assistant Professor of Pediatrics at the Division of Critical Care and Hospital Medicine, Columbia University.

Winifred Shen

Winifred Shen, MS is a Simulation Specialist and Statistician at Weill Cornell Medical College.

Kevin Ching

Kevin Ching, MD, FAAP is an Associate Professor of Emergency Medicine and Pediatrics, Weill Cornell Medicine.

Aliza B. Solomon

Aliza B. Solomon, DO is an Associate Professor of Clinical Pediatrics, Weill Cornell Medicine.

Kyle P. Burns

Kyle P. Burns, MFA is a Simulation Specialist at Weill Cornell Medical College.

Paul B. Martin

Paul B. Martin, MD, MPH is an Assistant Professor of Medicine, Weill Cornell Medicine.

Meredith L. Turetz

Meredith L. Turetz, MD is an Assistant Professor of Clinical, Weill Cornell Medicine.

Carl V. Crawford

Carl V. Crawford, MD is an Assistant Professor of Clinical Medicine, Weill Cornell Medicine.

Christine L. Joyce

Christine L. Joyce, MD is an Assistant Professor of Pediatrics, Weill Cornell Medicine.

Inna V. Landres

Inna V. Landres, MD is an Assistant Professor Obstetrics and Gynecology, Weill Cornell Medicine.

Kapil Rajwani

Kapil Rajwani, MD is an Associate Professor of Clinical Medicine, Weill Cornell Medicine.