Breaking bad news: A randomized controlled trial to test a novel interactive course for medical students using blended learning

Alessia Vincent; Tabita Urben; Christoph Becker; Katharina Beck; Christof Daetwyler; Michael Wilde; Jens Gaab; Wolf Langewitz; Sabina Hunziker

doi:10.1016/j.pec.2021.05.002

Breaking bad news: A randomized controlled trial to test a novel interactive course for medical students using blended learning

Patient Educ Couns. 2022 Jan;105(1):105-113. doi: 10.1016/j.pec.2021.05.002. Epub 2021 May 8.

Authors

Alessia Vincent¹, Tabita Urben², Christoph Becker³, Katharina Beck², Christof Daetwyler⁴, Michael Wilde⁴, Jens Gaab⁵, Wolf Langewitz⁶, Sabina Hunziker⁷

Affiliations

¹ Medical Communication and Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland; Division of Clinical Psychology and Psychotherapy, Faculty of Psychology, University of Basel, Basel, Switzerland.
² Medical Communication and Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland.
³ Medical Communication and Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland; Emergency Department, University Hospital Basel, Basel, Switzerland.
⁴ Faculty of Medicine, University of Basel, Basel, Switzerland.
⁵ Division of Clinical Psychology and Psychotherapy, Faculty of Psychology, University of Basel, Basel, Switzerland.
⁶ Medical Communication and Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland; Faculty of Medicine, University of Basel, Basel, Switzerland.
⁷ Medical Communication and Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland; Faculty of Medicine, University of Basel, Basel, Switzerland. Electronic address: Sabina.Hunziker@usb.ch.

PMID: 33994021
DOI: 10.1016/j.pec.2021.05.002

Abstract

Objective: Breaking bad news (BBN) is challenging for physicians and patients and specific communication strategies aim to improve these situations. This study evaluates whether an E-learning assignment could improve medical students' accurate recognition of BBN communication techniques.

Methods: This randomized controlled trial was conducted at the University of Basel. After a lecture on BBN, 4th year medical students were randomized to an intervention receiving an E-learning assignment on BBN or to a control group. Both groups then worked on an examination video and identified previously taught BBN elements shown in a physician-patient interaction. The number of correctly, misclassified and incorrectly identified BBN communication elements as well as missed opportunities were assessed in the examination video.

Results: We included 160 medical students (55% female). The number of correctly identified BBN elements did not differ between control and intervention group (mean [SD] 3.51 [2.50] versus 3.72 [2.34], p = 0.58). However, the mean number of inappropriate BBN elements was significantly lower in the intervention than in the control group (2.33 [2.57] versus 3.33 [3.39], p = 0.037).

Conclusions: Use of an E-learning tool reduced inappropriate annotations regarding BBN communication techniques.

Practice implications: This E-learning might help to further advance communication skills in medical students.

Keywords: Blended learning; Breaking bad news; Communication strategy; E-learning.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Clinical Competence
Communication
Education, Medical, Undergraduate* / methods
Female
Humans
Learning
Male
Physician-Patient Relations
Students, Medical*
Truth Disclosure