Addressing the competency of breaking bad news: What are Canadian general paediatric residency programs currently doing

Amrita Sarpal; Teneille E Gofton

doi:10.1093/pch/pxy124

Addressing the competency of breaking bad news: What are Canadian general paediatric residency programs currently doing

Paediatr Child Health. 2019 Jun;24(3):173-178. doi: 10.1093/pch/pxy124. Epub 2018 Oct 3.

Authors

Amrita Sarpal¹, Teneille E Gofton^{2

3}

Affiliations

¹ Department of Pediatrics, Western University Schulich School of Medicine and Dentistry, London, Ontario.
² Department of Clinical Neurological Sciences, Western University Schulich School of Medicine and Dentistry, London, Ontario.
³ Department of Critical Care, Western University Schulich School of Medicine and Dentistry, London, Ontario.

Abstract

Objective: To describe how breaking bad news (BBN) is currently taught in Canadian general paediatric residency programs and the confidence level of fourth year paediatric residents (Ped-PGY4) in BBN and managing end-of-life-care (EOLC).

Methods: A prospective, cross-sectional survey of General Paediatric Residency Program Directors (PDs) and Ped-PGY4s was conducted.

Results: When learning to BBN, residents state faculty observation (22/23) and interactive workshops (14/23) are the most helpful, while PDs state interactive workshops (9/16) and deliberate practice (5/16) are ideal. Residents identified a knowledge gap and discomfort with providing anticipatory guidance, and symptom management, including prescribing opioids.

Conclusions: In the era of competency-based medical education, there is an opportunity to create a standardized national curriculum addressing universal competencies related to BBN and EOLC.

Keywords: Breaking bad news; End-of-life-care; Medical education; Paediatrics; Residents.