Breaking bad news: self-perception of medical students

Ferreira, Esther Angélica Luiz; Brida, Fernanda Dermando; Curcelli, Emilio Martins; Valete, Cristina Ortiz Sobrinho

doi:10.1590/1983-80422022301506EN

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Research • Rev. Bioét. 30 (1) • Jan-Apr 2022 • https://doi.org/10.1590/1983-80422022301506EN copy

Breaking bad news: self-perception of medical students

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

This study analyzed medical students’ self-perception regarding their aptitude to communicate bad news and identify associated factors. Using a self-administered questionnaire, 44.1% of 214 participants considered themselves suitable for the approach. The following were associated with greater self-perception of aptitude for breaking bad news: more time in the course ( p <0.001); believing that the undergraduate course offered the necessary resources to acquire the skill to communicate bad news ( p <0.001); knowing a validated protocol ( p =0.015); having needed to communicate bad news during the undergraduate course ( p <0.001). In conclusion, most students felt unable to communicate bad news. Knowing a protocol and having the need to communicate bad news during the undergraduate course were essential for aptitude. As a suggestion, the topic should be approached differently, with more practical activities.

Health communication; Physician-patient relation; Education, higher

Question	Number of responses	%
Have you already had your first contact with the BBN topic in the undergraduate curriculum?
Yes No	173 41	80.9 19.1
Total responses	214	100.0
In what year the first contact occurred?
1^styear 2^ndyear 3^rdyear 4^thyear 5^thyear	87 49 20 13 3	50.6 28.5 11.6 7.6 1.7
Total responses	172	80.4
Have you had contact with the BBN topic in an extracurricular activity?
Yes No	147 67	68.7 31.3
Total responses	214	100.0
Do you consider the BBN topic important for a medical career?
Yes No	210 3	98.6 1.4
Total responses	213	99.5
Do you know a validated protocol for BBN assistance?
Yes No	132 81	62.0 38.0
Total responses	213	99.5
If yes, where did you learn it?
University College/conferences, symposia Congresses, symposia Internet Others	92 15 7 5 13	69.7 11.3 5.3 3.8 9.9
Total responses	132	61.7
In how many situations during your undergraduate course were you required to BBN?
None Once Twice More than twice	106 29 28 42	51.7 14.1 13.7 20.5
Total responses	205	95.8
Do you believe the BBN subject is essential in undergraduate course?
Yes No	199 5	97.5 2.5
Total responses	204	95.3
Do you believe that your undergraduate course offers the necessary resources to acquire the BBN skill?
Yes No	120 81	59.7 40.3
Total responses	201	93.9
Do you consider yourself suitable for BBN?
Yes No	93 118	44.1 55.9
Total responses	211	98.6
What do you consider your most significant difficulty?
Nervousness I believe that bad news is bad for the patient I wouldn’t know how to break the news I wouldn’t know how to deal with the patients’ reaction I don’t believe I, a physician, should have this task Other	92 23 58 103 2 18	43.0 10.7 27.1 48.1 0.9 8.4
Total responses	214	100.0

Variable	n	%	Aptitude for BBN (%)	PR	p -value
Having communicated bad news during the undergraduate course
Yes No	99 106	48.30 51.70	71.71 18.86	3.84 1	<0.001
Year of the course
4^thto 6^th 1^stto 3^rd	104 107	49.3 50.7	70.20 18.70	3.75 1	<0.001
Knowing a validated protocol for BBN
Yes No	132 81	62.0 38.0	58.33 19.75	2.99 1	<0.001
Having had first contact with BBN during the undergraduate course
Yes No	173 41	80.9 19.1	49.71 17.07	2.87 1	0.003
Believing that the undergraduate course offered the necessary resources to acquire the BBN skill
Yes No	120 81	59.7 40.3	55.83 27.16	1.99 1	<0.001
Having had contact with BBN in extracurricular activities
Yes No	147 67	68.7 31.3	48.29 32.83	1.50 1	0.037

Variable	APR	95% CI	p -value
Year of course	2.52	1.54-4.13	<0.001
Believing that the undergraduate course offered the necessary resources to acquire the BBN skill	2.03	1.45-2.82	<0.001
Knowing a validated protocol for BBN	1.70	1.10-2.63	0.015
Having communicated bad news during the undergraduate course	1.07	1.04-1.11	<0.001

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E-mail: bioetica@portalmedico.org.br

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[1] Correspondence: Esther Angélica Luiz Ferreira – Universidade Federal de São Carlos. Rod. Washington Luiz, 310, km 235 CEP 13565-905. São Carlos/SP, Brasil.