scholarly journals ACACIAS Project: Physiological and Subjective Effects of High-fidelity Simulation During Delivery of Bad News in Oncology

Author(s):  
Elise Deluche ◽  
Henri Salle ◽  
Sophie Leobon ◽  
Teeva Facchini-Joguet ◽  
Alexandre Troussel ◽  
...  

Abstract Background: Delivering bad news is difficult and requires specific training, but this training can be accomplished through high-fidelity simulation (HFS). This prospective study was conducted to objectively evaluate the emotional impact of HFS as an effective tool to develop clinical proficiency.Methods: This prospective feasibility study was conducted from January 2021 to May 2021. Students received a 1- or 2-day training course. The emotional impact of the intervention was evaluated by self-questionnaire and by an Affect-tag wristband that analysed Emotional power (EP), Emotional density (ED), and Cognitive load (CL).Results: The study population included 46 students with a median age of 25 years (range 21–34 years). Participants were emotionally and effectively involved in the HFS training without being completely overpowered by emotions, which may be an inherent feature of the training format. Students who participated twice improved their EP (p < 0.001) and decreased their ED (p = 0.005). CL remained stable (p = 0.751). The mean time of the first and second training increased (1:41 vs. 2:16, p = 0.02). Skills improved as assessed by self-questionnaires and by outsiders (actor/nurse).Conclusion: HFS is a good method for this type of training, considering the emotional impact. Training in delivering bad news was improved through objective practice and self-assessment by participants.

2017 ◽  
Author(s):  
Anne-Christine Rat ◽  
Laetitia Ricci ◽  
Francis Guillemin ◽  
Camille Ricatte ◽  
Manon Pongy ◽  
...  

BACKGROUND Although most physicians in medical settings have to deliver bad news, the skills of delivering bad news to patients have been given insufficient attention. Delivering bad news is a complex communication task that includes verbal and nonverbal skills, the ability to recognize and respond to patients’ emotions and the importance of considering the patient’s environment such as culture and social status. How bad news is delivered can have consequences that may affect patients, sometimes over the long term. OBJECTIVE This project aimed to develop a Web-based formative self-assessment tool for physicians to practice delivering bad news to minimize the deleterious effects of poor way of breaking bad news about a disease, whatever the disease. METHODS BReaking bAD NEws Tool (BRADNET) items were developed by reviewing existing protocols and recommendations for delivering bad news. We also examined instruments for assessing patient-physician communications and conducted semistructured interviews with patients and physicians. From this step, we selected specific themes and then pooled these themes before consensus was achieved on a good practices communication framework list. Items were then created from this list. To ensure that physicians found BRADNET acceptable, understandable, and relevant to their patients’ condition, the tool was refined by a working group of clinicians familiar with delivering bad news. The think-aloud approach was used to explore the impact of the items and messages and why and how these messages could change physicians’ relations with patients or how to deliver bad news. Finally, formative self-assessment sessions were constructed according to a double perspective of progression: a chronological progression of the disclosure of the bad news and the growing difficulty of items (difficulty concerning the expected level of self-reflection). RESULTS The good practices communication framework list comprised 70 specific issues related to breaking bad news pooled into 8 main domains: opening, preparing for the delivery of bad news, communication techniques, consultation content, attention, physician emotional management, shared decision making, and the relationship between the physician and the medical team. After constructing the items from this list, the items were extensively refined to make them more useful to the target audience, and one item was added. BRADNET contains 71 items, each including a question, response options, and a corresponding message, which were divided into 8 domains and assessed with 12 self-assessment sessions. The BRADNET Web-based platform was developed according to the cognitive load theory and the cognitive theory of multimedia learning. CONCLUSIONS The objective of this Web-based assessment tool was to create a “space” for reflection. It contained items leading to self-reflection and messages that introduced recommended communication behaviors. Our approach was innovative as it provided an inexpensive distance-learning self-assessment tool that was manageable and less time-consuming for physicians with often overwhelming schedules.


2018 ◽  
Vol 20 (1) ◽  
Author(s):  
Viola Janse van Vuuren ◽  
Eunice Seekoe ◽  
Daniel Ter Goon

Although nurse educators are aware of the advantages of simulation-based training, some still feel uncomfortable to use technology or lack the motivation to learn how to use the technology. The aging population of nurse educators causes frustration and anxiety. They struggle with how to include these tools particularly in the light of faculty shortages. Nursing education programmes are increasingly adopting simulation in both undergraduate and graduate curricula. The aim of this study was to determine the perceptions of nurse educators regarding the use of high fidelity simulation (HFS) in nursing education at a South African private nursing college. A national survey of nurse educators and clinical training specialists was completed with 118 participants; however, only 79 completed the survey. The findings indicate that everyone is at the same level as far as technology readiness is concerned, however, it does not play a significant role in the use of HFS. These findings support the educators’ need for training to adequately prepare them to use simulation equipment. There is a need for further research to determine what other factors play a role in the use of HFS; and if the benefits of HFS are superior to other teaching strategies warranting the time and financial commitment. The findings of this study can be used as guidelines for other institutions to prepare their teaching staff in the use of HFS.


2018 ◽  
Vol 17 (1) ◽  
pp. 160940691879160 ◽  
Author(s):  
Andrew Stuart Lane ◽  
Chris Roberts

The interview is an important data-gathering tool in qualitative research, since it allows researchers to gain insight into a person’s knowledge, understandings, perceptions, interpretations, and experiences. There are many definitions of reflexivity in qualitative research, one such definition being “Reflexivity is an attitude of attending systematically to the context of knowledge construction, especially to the effect of the researcher, at every step of the research processes.” The learning pathways grid (LPG) is a visual template used to assist analysis and interpretation of conversations, allowing educators, learners, and researchers, to discover links from cognition to action, usually in a retrospective manner. It is often used in simulation educational research, with a focus on understanding how learners access their cognitive frames and underlying beliefs. In this article, we describe the use of the LPG as a prospective adjunct to data collection for interviews and focus groups. We contextualize it within a study among medical interns and medical students who were engaged in high-fidelity simulation exploring open disclosure after a medication error. The LPG allowed future optimization of data collection and interpretation by ensuring reflexivity within the researchers, a vital part of research conduct. We conclude by suggesting the use of the LPG has a reasonable fit when taking a social constructivist approach and using qualitative analysis methods that make reflexivity explicit and visible, therefore ensuring it is truly considered, understood, and demonstrated by researchers.


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