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How to break bad news and how to learn this skill: results from an international North-Eastern German Society for Gynecological Oncology (NOGGO) survey among physicians and medical students with 1089 participants

Authors
  • Herzog, Emilie M1
  • Pirmorady Sehouli, Adak2, 3
  • Boer, Jolijn4
  • Pietzner, Klaus1
  • Petru, Edgar5
  • Heinzelmann, Viola6
  • Roser, Eva1
  • Dimitrova, Desislava1
  • Oskay-Özcelik, Gülten4
  • Camara, Oumar4, 7
  • Sehouli, Jalid8, 3
  • 1 Department of Gynecology, Center for Oncological Surgery, Campus Virchow Klinikum, Charité University Hospital Berlin, Berlin, Germany. , (Germany)
  • 2 Department of Psychosomatic Medicine, Charité University Hospital Berlin, Berlin, Germany. , (Germany)
  • 3 European Art Guild for Medicine and Culture, Berlin, Germany. , (Germany)
  • 4 North-Eastern German Society for Gynecological Oncology (NOGGO eV), Berlin, Germany. , (Germany)
  • 5 Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria. , (Austria)
  • 6 Department of Gynecology and Gynecological Oncology, University Hospital Basel, Basel, Switzerland. , (Switzerland)
  • 7 Department of Gynecological Oncology and Breast Centre, Helios Hospital Gotha, Gotha, Germany. , (Germany)
  • 8 Department of Gynecology, Center for Oncological Surgery, Campus Virchow Klinikum, Charité University Hospital Berlin, Berlin, Germany [email protected]. , (Germany)
Type
Published Article
Journal
International Journal of Gynecological Cancer
Publisher
Ovid Technologies (Wolters Kluwer) - Lippincott Williams & Wilkins
Publication Date
Dec 04, 2023
Volume
33
Issue
12
Pages
1934–1942
Identifiers
DOI: 10.1136/ijgc-2023-004693
PMID: 38052472
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Delivering bad news to patients is one of the most challenging tasks in medical practice. Despite its great relevance to patients, relatives, and medical staff, there is a paucity of data pertaining to training, experience, expectations, and preferences of physicians and medical students on breaking bad news. We conducted an international survey in Germany, Switzerland, and Austria using an online questionnaire among physicians and medical students. A total of 786 physicians and 303 medical students completed the survey. Physicians stated that 32.7% deliver bad news several times a week and 45.2% several times a month. Difficulties controlling their emotions (35.1%) and remaining professional (43.4%) were the greatest challenges for physicians. Delivering bad news is associated with feelings of anxiety, both among experienced physicians (median of 3.8 out of 10.0) and medical students (median of 5.3). Conveying bad news is a burden to physicians and consequently has a substantial impact on their job satisfaction. All participants reported the need for more communication training concerning this subject. Only 49.5% of medical students and 67.3% of physicians mentioned having learned adequate communication skills. Our data demonstrate that communication training decreases the level of anxiety and increases the feeling of self-confidence towards breaking bad news. Preferred educational tools were seminars with simulation (students: 71.4%, physicians: 49.5%), observing more senior faculty (students: 57.4%, physicians: 55.1%), and supervision and feedback sessions (students: 36.3%, physicians: 45.7%). The largest barriers regarding education on communication were limited time (students: 77.0%, physicians: 74.9%) and missing awareness of supervisors (students: 60.6%, physicians: 41.1%). Our study showed a great need for systematic training and education in breaking bad news among physicians and medical students. Hospitals, medical schools, and postgraduate training programs are strongly encouraged to fill this gap, and improve sustainable doctor-patient communication to overcome the psychological burden for physicians. © IGCS and ESGO 2023. Re-use permitted under CC BY-NC. No commercial re-use. Published by BMJ.

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