Helping medical students to acquire a deeper understanding of truth-telling

被引:12
|
作者
Hurst, Samia A. [1 ]
Baroffio, Anne [2 ]
Ummel, Marinette [1 ,3 ]
Burn, Carine Layat [2 ,4 ]
机构
[1] Univ Geneva, Sch Med, Inst Eth Hist & Humanities, CH-1211 Geneva 4, Switzerland
[2] Univ Geneva, Sch Med, Unit Dev & Res Med Educ, CH-1211 Geneva 4, Switzerland
[3] CURML Univ Ctr Legal Med, Lausanne, Switzerland
[4] Univ Appl Sci, HE ARC, Dept Nursing, Neuchatel, Switzerland
来源
MEDICAL EDUCATION ONLINE | 2015年 / 20卷
基金
瑞士国家科学基金会;
关键词
clinical education; ethics and humanities; communication skills; BREAKING BAD-NEWS; PATIENT-CENTERED CARE; OF-THE-LITERATURE; STANDARDIZED PATIENTS; SIMULATED PATIENTS; CLINICAL CLERKS; 1ST YEAR; EMPATHY; EDUCATION; ATTITUDES;
D O I
10.3402/meo.v20.28133
中图分类号
G40 [教育学];
学科分类号
040101 ; 120403 ;
摘要
Problem: Truth-telling is an important component of respect for patients' self-determination, but in the context of breaking bad news, it is also a distressing and difficult task. Intervention: We investigated the long-term influence of a simulated patient-based teaching intervention, integrating learning objectives in communication skills and ethics into students' attitudes and concerns regarding truth-telling. We followed two cohorts of medical students from the preclinical third year to their clinical rotations (fifth year). Open-ended responses were analysed to explore medical students' reported difficulties in breaking bad news. Context: This intervention was implemented during the last preclinical year of a problem-based medical curriculum, in collaboration between the doctor-patient communication and ethics programs. Outcome: Over time, concerns such as empathy and truthfulness shifted from a personal to a relational focus. Whereas 'truthfulness' was a concern for the content of the message, 'truth-telling' included concerns on how information was communicated and how realistically it was received. Truth-telling required empathy, adaptation to the patient, and appropriate management of emotions, both for the patient's welfare and for a realistic understanding of the situation. Lessons learned: Our study confirms that an intervention confronting students with a realistic situation succeeds in making them more aware of the real issues of truth-telling. Medical students deepened their reflection over time, acquiring a deeper understanding of the relational dimension of values such as truth-telling, and honing their view of empathy.
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页数:11
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