Comunicação de más notícias pelos médicos no primeiro ano de internato: um estudo exploratório

Abstract

Introduction. Understanding the difficulties in breaking bad news of doctors recently graduated from medical school is important to guide the development of undergraduate education in this area of patient-physician communication.Aim. To explore the perceptions of medical graduates at the end of their fi rst year of residency, concerning their present preparation for breaking bad news and the desirable characteristics of eff ective undergraduate medical curricula in this area.Subjects and methods. This was a qualitative exploratory study with two focus groups of fi rst year residents (n = and n = 7) of a hospital in Portugal. The focus group sessions were audio-recorded, transcribed and subjected to thematic analysis.Results.The residents reported difficulties and insecurity in breaking bad news, even though they considered having good communication skills in general. Their main difficulties were to deal with the emotions and reactions of the physician and patient, such as crying and silence. Previous negative experiences conditioned their security in breaking bad news. The main limitations acknowledged in their undergraduate training in this area, were early and disjointed education in curricula and the lack of practical training.Conclusion. The improvement of medical training in breaking bad news should pay attention to the emotional aspects of the process. Undergraduate medical curricula should be designed longitudinally, involving simulation as well as real contexts.