Artikel
Highly emotionally loaded breaking bad news (BBN) scenarios: how to promote a Simulated Patients (SP) team’s motivation
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Veröffentlicht: | 5. September 2016 |
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Question: In 2012-2013, we conducted a study about teaching BBN. During one semester, each week, SPs had to do several encounters in a row with students announcing them fatal diagnosis. After this two years study, more than half of the SPs no longer wanted to play BBN. In order to have a stable SP team, we explored how to promote their motivation.
Method: After each year, we conducted formal group interviews with the SPs, using an inductive method of analysis. Based on the results, we adapted the format of the teaching sessions. After implementing changes, we audiotaped another focus groups to evaluate their impact.
Results: Based on the interviews, the main issues were: severity of the case, number of encounters in a row, break length, feedback, debriefing opportunity, and meaning of the work. Playing a desperate situation with six students in a row was felt very painful. A maximum of four encounters was seen as sustainable, with a break in the middle. Giving feedback to students was perceived as a way for SPs to feel useful to the student and to be part of the teaching process. After implementing changes, the SPs were satisfied and willing to play the role again next year.
Discussion: BBN scenarios are highly emotionally loaded. Their impact must not be underestimated. We must pay special attention and adequately accompany the SPs playing such roles. Improving the playing conditions and giving a real sense to the work helps motivating the SPs: we adapted the role content, number of encounters, break length with success. Special emphasis was put on feedback, which increases SPs’ perceived usefulness to students. During the sessions, we offered individual debriefing and feedback. These changes increased SPs’ willingness to play the role again.
Conclusion: In order to keep an experimented and motivated team of SPs playing BBN roles, it is important to take special care of them, help them to distance themselves from the role and make them feel part of the teaching process, as they ultimately feel they help improving future care of patients.
References
- 1.
- Abe K, Roter D, Erby LH, Ban N. A nationwide survey of standardized patients: who they are, what they do, and how they experience their work. Patient Educ Couns. 2011;84(2):261-264. DOI: 10.1016/j.pec.2010.07.017
- 2.
- Bokken L, Van Dalen J, Rethans JJ. The impact of simulation on people who act as simulated patients: a focus group study. Med Educ. 2006;40(8):781-786. DOI: 10.1111/j.1365-2929.2006.02529.x
- 3.
- Mc Naughton N, Tiberius R, Hodges B. Effects on Portraying Psychologically and Emotionnally Complex Standardized Patients Roles. Teach Learn Med. 1999;11(3):135-141. DOI: 10.1207/S15328015TL110303
- 4.
- Naftulin DH, Andrews BJ. The effects of patient simulations on actors. J Med Educ. 1975;50(1):87-89. DOI: 10.1097/00001888-197501000-00015
- 5.
- Spencer J, Dales J. Meeting the needs of simulated patients and caring for the person behind them? Med Educ. 2006;40(1):3-5. DOI: 10.1111/j.1365-2929.2005.02375.x
- 6.
- Trivi-o X, Ferrer L, Bernales M, Cianelli R, Moore P, Peragallo N. Effect of emotionally complex roles on HIV-related simulated patients. Hisp Health Care Int. 2013;11(2):72-77. DOI: 10.1891/1540-4153.11.2.72
- 7.
- Woodward C, McConvey-Gliva G. The effect of simulating on standardized patients. Acad Med. 1995;70(5):418-420. DOI: 10.1097/00001888-199505000-00020