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Disclosure of damage related to care is a difficult area of communication due to the physician’s feeling of guilt or the fear of liability. The aim of this study was to develop, and to evaluate the impact of an inter-disciplinary simulation program on communication of damage related to care.
Residents in gynecology/obstetrics and anesthesiology participated in role-playing scenarios of communication of damage related to care. We assessed verbal, non-verbal communication skills and inter-disciplinary relations with a modified SPIKES protocol and with a video analysis with predefined indicators. We evaluated long-term impact of the training at 3-6 months with combining self-assessment and a video analysis on retained knowledge.
We included 80 residents in 15 sessions of simulation. Satisfaction regarding the simulation training was high (9.1/10 [8.9-9.3]). The part of the SPIKES protocol “setting up the interview” was the more difficult to apply. Empathic attitude was adopted 80% of the time in the two scenarios with a life-threatening complication but was less common in the anesthetic one (broken tooth). The residents found interdisciplinary disclosure helpful due to support from the other resident. Immediately after the session, residents reported an important improvement in communication skills and that the session would significantly change their practice. At 3 to 6 months, reports were still largely positive but less than on immediate evaluation.
Residents did not master the most important communication skills. The interdisciplinary method to breaking bad news was felt useful.Le texte complet de cet article est disponible en PDF.
Keywords : interdisciplinary communication, simulation, breaking bad news, patient harm