gms | German Medical Science

Question: Referring to the results of the Basel Consensus Statement “communicative and social competencies in medical education that estimates personality and professionalism as one of the most important competencies, the aim of this study was to investigate inter-actions of emotional perception according to professional identity and self-assessment of clinical competence in emotionally burdened situations (breaking bad news) [1].

Methods: In the winter semester of 2008/09, a longitudinal study was conducted wherein data was collected of 108 medical students (return rate 93.9%), all taking part in the one week course “Psychosomatics”. An anonymous questionnaire was given at three different intervals: T1 before the training of “Breaking Bad News” with T2 immediately after, T3 after the final exam which included „Breaking Bad News“with simulated patients. In the questionnaire, the students were asked to give estimations of their professional identity, about their competence on breaking bad news, and on their current emotional state judged on 15 different items. With the use of a factorial analysis, these 15 items were summarised on three scales: “motivation”, “positive emotions” and “negative emotions” (Cronbach’s alpha > .70). With the use of multivariate variance analysis with repeated measures (General Linear Model, SPSS 15.0), the data and the covariate of professional identity were checked for any significant changes occurring between the test intervals.

Results: In total, we identified significantly differing groups concerning professional identity and self assessment of the competence “breaking bad news.”

Group A (n=46) showed significantly higher values concerning professional identity and self assessment in “breaking bad news” before training course than group B (n= 61). In group A, training of breaking bad news with simulated patients caused highly significant irritation in personal identity even though self assessment of breaking bad news improved. Confidence in own personal identity could not be restored until the end of the course, while group B experienced continuous improvement of personal identity and self assessment of breaking bad news. However, a significant difference between the two groups concerning development of negative emotions during the course could not be found, whereas group B developed an increase of positive emotions in addition to a significant higher improvement of self-assessment in “breaking bad news”.

Conclusion: The experience of self-competence in emotionally burdened situations (breaking bad news) during the psychosomatic course is individual and has consecutive effects on professional identity. Adequate self-estimation and guided experience of self competence in difficult situations seems to be a meaningful focus of medical education with regard to professionalism and personality even on undergraduate level.