Breaking bad news: enhancing PA student competencies around difficult patient discussions
Wong, Cassandra Marie
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BACKGROUND: The ability to disclose bad news to patients is a complex and essential skill for health care providers. Although certain specialties have a higher incidence of engaging in these conversations, this task is done regardless of a provider’s discipline. There are many components to breaking bad news, some of which include finding a private setting, eliciting how much the patient wants to know, providing clear information, and responding to the patients’ emotional needs and reactions. As this task is associated with a large amount of emotional stress, the outcome of this exchange can have lasting impact on both the provider and patient. Unfortunately, patients are dissatisfied with how they receive bad news, and providers admit to lack of comfort and knowledge with this task. LITERATURE REVIEW FINDINGS: Studies show that inadequate education is main area for improvement. Fortunately, the ability to break bad news is a teachable and retainable skill. Didactic sessions, role-play, and small groups are some of the available models used to educate learners. There is promising evidence for the incorporation of SPs into various curricula, because they provide an opportunity for students to learn without compromising patient safety and allow for feedback useful to enhancing skills. PAs are valued health care providers who practice across a variety of specialties. As their education is similar to that of a medical student, and they practice autonomously under the supervision of a physician, it is equally important that they are able to successfully break bad news. However, there are few studies that examine the PA student curriculum for breaking bad news education. Furthermore, there are no studies that examine PA student competency with this skill. PROPOSED PROJECT: The goal of this study is to use a literature review to create a novel curriculum that employs SPs to increase PA students’ competencies for breaking bad news. CONCLUSIONS: An optimal curriculum intervention will include opportunities for feedback, discussion, and practice. SPs can help aid with many of these components, as well as assess interpersonal and technical components of breaking bad news. SIGNIFICANCE: It is expected that the results of this study will parallel those identified for medical students, and PA students’ skills will improve to meet the standards set forth by the ARC-PA. It is the hope that the results of this study will serve as an initial platform for future studies aimed at PAs’ ability to disclose bad news to patients.