Fujimori and collaborators; 2014 21; Fujimori and collaborators; 2014 22
|
JP |
30 oncologists and 580 patients |
Oncologists e patients |
Longitudinal |
Questionnaires evaluating knowledge were given to oncologists. A group of oncologists attended workshop training on communication, while another group did not receive training. Follow up with patients took place. |
Simulation with patients was taped and evaluated by patients on an 11-point scale. Oncologists who received training in BBN had better results than those who did not. The workshop was well evaluated by oncologists and they felt more confident in BBN after the intervention. |
Setubal and collaborators; 2018 39
|
BR |
61 |
Perinatology residents |
Longitudinal |
Residents met a SP and were allocated to control and intervention (Spikes) groups. After the intervention, both groups met a SP again. |
There was no difference between intervention and control groups. The second session with the SP was better, showing practice leads to success. The experience was well-rated. |
Karam and collaborators; 2017 40
|
USA |
16 |
Anesthesiology residents |
Longitudinal |
The BBN experiences with GRIEV_ING check-list were obtained using simulators with a high fidelity to immersive experiences. After that, role-playing with SP complemented the experiences. |
Performance in case 1 did not vary in relation to the year of training. Pre-test scores were lower than post-test scores on the GRIEV_ING check-list. Also, before the workshop, 52% rated their competence in BBN as good and very good. This number increased to 93% after the workshop, with an increase in confidence as well. |
Cohen and collaborators; 2016 41
|
USA |
26 |
Nephrology fellows |
Longitudinal |
Fellows were assigned to three cases about treatment, how to break bad news and to discuss prognosis |
Respondents affirmed their development went from “not prepared” to “very well prepared”. Also, they rated the course as excellent. |
von Lengerke, Kursch, Lange; 2011 42
|
DE |
267 (100) |
Medical students |
Longitudinal |
Students were assigned to seven sessions lasting four hours each, containing theory about physician-patient communication, practical exercises, nonverbal communication, video-classes, cases, disclosure of a diagnosis and role-playing. |
Most students fully agreed with the teaching methods and subjects, affirming progress in communication. |
Abel and collaborators; 2001 43
|
UK |
140 |
Senior doctors and nurses |
Longitudinal |
A course was developed for doctors and nurses with previous training in communication. Areas that needed improvement were investigated and implemented in the project |
They all agreed the course was important and most of them thought BBN was the most useful part. Also, there was an increase in confidence on how to deliver bad news. |
Alexander and collaborators; 2006 44
|
USA |
56 |
Medical residents |
Longitudinal |
16-hour curriculum that included control of pain and symptoms, communication skills (BBN) and ethics. Groups were divided into control and intervention, and they were evaluated before and after the approach. |
Both groups had the same prior training. After the training, the intervention group had much higher scores. |
Sombra Neto and collaborators; 2017 45
|
BR |
119 |
Medical students |
Longitudinal |
Students watched theoretical weekly classes and participated in practical BBN simulations, with simulated patients and training in pairs |
67% of students presented an excellent score (>90%), 7% was considered regular or bad. 16% concluded the test with the maximum score and the lowest score was 68%. |
Burn and collaborators; 2014 46
|
CH |
225 |
Medical students |
Longitudinal |
In this cohort trial, the intervention group received training in ethics, truth-telling and BBN. Students were evaluated by questionnaires before and after the approach. |
Students’ ethical attitudes regarding truth-telling remained stable, but they started to feel more comfortable about those situations, and two thirds of students who did not feel confident before felt confident afterwards. |
Hurst and collaborators; 2015 47
|
CH |
225 |
Medical students |
Longitudinal |
Students participated in encounters with 3 simulated patients and received feedback to understand their progress. Intervention was composed of a 90-minute talk with SP, a 15-minute ethical discussion and a 60-minute communication skills practice |
Students ethical attitudes remained stable. They developed new skills following the intervention, and increased their awareness of the difficulties and challenges raised by BBN situations, allowing them to resolve their weaknesses |
Skye and collaborators; 2014 48
|
USA |
451 |
Medical students |
Longitudinal |
Students watched a simulation about a woman with colon cancer. After that, they discussed empathy, doctors, gender, dynamics, power and support |
The intervention was well received (94% agreed or strongly agreed with the method). They valued the strategy. |
Parikh and collaborators; 2017 49
|
USA |
105 |
Medical students |
Longitudinal |
Questionnaires about how participants rated the intervention which was composed of discussions and role-playing, and whether they retained the training after 1 year |
Students rated the intervention as essential for medical education and affirmed feeling more capable of discussing life and death with patients. Results were evaluated after 1 year (12-24 months) |
Ellman, Fortin; 2012 50
|
USA |
1455 |
Medical students |
Cross-sectional |
Communicating Difficult News Workshop and Ward-Based End-of-Life Care Assignment, which was developed at Yale Medical School. |
Not evaluated |
Szmuilowicz and collaborators; 2010 51
|
USA |
56 |
Internal medicine residents |
Longitudinal |
Residents were assigned to a control or intervention group, which was addressed with a combination of teaching styles and skills practice |
Residents in the intervention group showed an improvement in communication (treatment options and prognosis) and ability to show emotional support. Also, they felt more confident. These changes were not seen in the control group. |