Key Points
- Breaking bad news (BBN) is a challenging but essential medical task, causing emotional strain for both physicians and patients.
- Effective BBN relies on both verbal and nonverbal communication, which can be impaired by stress.
- The study investigates the effects of two interventions on medical students’ BBN communication performance: Stress Arousal Reappraisal (SAR) and Worked Example (WE).
- Stress Arousal Reappraisal (SAR): Positive reframing of stress arousal as beneficial and functional, aiming to shift from a threat state to a challenge state.
- Worked Example (WE): Step-by-step demonstration of BBN, designed to optimize cognitive load and facilitate schema acquisition.
- Pre-registered randomized controlled trial with a 2×2 between-subjects design.
- 221 third-year medical students participated.
- Students completed a 40-min web-based learning module (including a written BBN SPIKES protocol) before a 12-min simulated BBN consultation with a standardized patient (disclosing a Trisomy 21 diagnosis).
- Performances were video-recorded and assessed by three independent raters for verbal (mean of six SPIKES items) and nonverbal communication.
Key Findings
- Worked Example (WE) Intervention: Significantly improved both verbal and nonverbal communication performance.
- Stress Arousal Reappraisal (SAR) Intervention: Enhanced nonverbal communication only.
- Combined Interventions: Combining SAR with WE did not yield additional improvements in nonverbal communication beyond those achieved by either intervention alone.
Key Clinical Points
- Practical Training Tools: Both SAR and WE interventions are promising, low-threshold tools for equipping medical students with essential BBN communication skills.
- Addressing Stress in BBN: The study highlights the importance of stress coping in effectively delivering bad news, a previously overlooked aspect in BBN training.
- Efficiency in Medical Curricula: These interventions are well-suited for integration into time-constrained medical curricula due to their efficiency.
- Holistic Communication Improvement: WE is effective for both verbal and nonverbal communication, while SAR specifically aids nonverbal aspects, suggesting a multi-faceted approach to training.
- Further research is needed to explore the interaction effects between SAR and WE, as their combined effects were not synergistic in this study.
- The study’s use of a prenatal setting for BBN, while challenging for third-year students, allowed a focus on communication rather than medical knowledge, and addresses an often-overlooked area in medical training.
"Empowering Future Doctors: Stress Reappraisal and Worked Examples Enhance Breaking Bad News Communication Skills"
The Perfect Grind: How Premium Coffee Grinders Elevate Your Brewing Experience
This review examines the top coffee grinders of 2024, designed for coffee enthusiasts seeking perfect grind consistency. From burr grinders to high-tech adjustable models, these devices ensure that every cup of coffee you brew is made from perfectly ground beans. We’ll look into grind precision, speed, and how each grinder affects the flavor of your brew.
3.8 / 5
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Grind Consistency and Precision
5/5 AmazingEquipped with conical burrs, these grinders excel at delivering a uniform grind size, crucial for making espresso, French press, or drip coffee.
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Build and Motor Durability
3/5 GoodBuilt from stainless steel with robust motors, these machines are built to last, handling heavy use while ensuring minimal overheating during operation.
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Noise Levels and Operation
3/5 GoodWhile powerful, some grinders generate higher noise levels, making them less suitable for quiet morning coffee routines.
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Ease of Cleaning and Maintenance
4/5 ExcellentDesigned with removable parts and easy access to burrs, these grinders are simple to maintain, though finer grinds may require more frequent cleaning.
Pros
- Excellent consistency
- Long-lasting motor
Cons
- Noisy
- Frequent cleaning required
