Is it possible to improve residents breaking bad news skills A randomised study assessing the efficacy of a communication skills training program

Abstract

Background:This study aims to assess the efficacy of a 40-h training programme designed to teach residents the communication skills needed to break the bad news.Methods:Residents were randomly assigned to the training programme or to a waiting list. A simulated patient breaking bad news (BBN) consultation was audiotaped at baseline and after training in the training group and 8 months after baseline in the waiting-list group. Transcripts were analysed by tagging the used communication skills with a content analysis software (LaComm) and by tagging the phases of bad news delivery: pre-delivery, delivery and post-delivery. Training effects were tested with generalised estimating equation (GEE) and multivariate analysis of variance (MANOVA).Results:The trained residents (n50) used effective communication skills more often than the untrained residents (n48): more open questions (relative rate (RR)5.79; P<0.001), open directive questions (RR1.71; P0.003) and empathy (RR4.50; P0.017) and less information transmission (RR0.72; P0.001). The pre-delivery phase was longer for the trained (1min 53s at baseline and 3min 55s after training) compared with the untrained residents (2min 7s at baseline and 1min 46s at second assessment time; P<0.001).Conclusion:This study shows the efficacy of training programme designed to improve residents' BBN skills. The way residents break bad news may thus be improved.