Improving breaking bad news communication skills through stress arousal reappraisal and worked examples.

Introduction: Breaking bad news (BBN) is a distressing yet essential task in medicine, imposing emotional strain on both physicians and patients. Crucially, effective BBN relies on both verbal and nonverbal communication, which can be impaired by elevated stress associated with the task. Efficient t...

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Publicado en:Medical Education Vol. 59; no. 8; pp. 853 - 862
Autores principales: Bosshard, Michel, Guttormsen, Sissel, Nater, Urs Markus, Schmitz, Felix, Gomez, Patrick, Berendonk, Christoph
Formato: cartoon research tables/charts randomized controlled trial Journal Article
Publicado: Wiley-Blackwell Aug2025
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Aug2025
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        atl: Improving breaking bad news communication skills through stress arousal reappraisal and worked examples.
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        au:
          Bosshard, Michel
          Guttormsen, Sissel
          Nater, Urs Markus
          Schmitz, Felix
          Gomez, Patrick
          Berendonk, Christoph
        affil: Institute for Medical Education, University of Bern, Bern, Switzerland
      sug:
        subj:
          Truth Disclosure
          Communication Methods
          Education, Medical
          Students, Medical Psychosocial Factors
          Stress, Psychological Prevention and Control
          Clinical Competence
          Physician-Patient Relations
          Human
          Funding Source
          Randomized Controlled Trials
          Random Assignment
          Internet
          Patient Simulation
          Videorecording
          Nonverbal Communication
          Arousal
          Teaching Materials
          Students, Undergraduate
      ab: Introduction: Breaking bad news (BBN) is a distressing yet essential task in medicine, imposing emotional strain on both physicians and patients. Crucially, effective BBN relies on both verbal and nonverbal communication, which can be impaired by elevated stress associated with the task. Efficient teaching of communication skills continues to present a challenge, and the role of stress management in BBN encounters remains largely overlooked. In this study, we investigated the effects of stress arousal reappraisal (SAR; positive reframing of stress arousal) and worked example (WE; step‐by‐step demonstration of BBN) interventions on medical students' communication performance. Methods: This pre‐registered randomised controlled trial employed a 2 × 2 between‐subjects design to evaluate the individual and combined effects of SAR and WE interventions on the verbal and nonverbal communication performance of 221 third‐year medical students. To do so, students completed a 40‐min web‐based learning module before disclosing bad news to a simulated patient within a 12‐min consultation. Performances were videorecorded and assessed by three independent raters. Results: The WE intervention significantly improved both verbal and nonverbal communication performance, whereas the SAR intervention enhanced nonverbal communication only. Combining SAR with WE did not yield additional improvements in nonverbal communication beyond those achieved by either intervention alone. Discussion: These findings highlight the potential of both SAR and WE interventions to optimise resource‐intensive simulated BBN training. By demonstrating the efficacy of WE in improving both verbal and nonverbal communication, this study advances the literature on the application of WEs in the BBN context. Furthermore, this study is among the first to demonstrate the importance of stress coping in delivering bad news effectively. Given their low threshold, both SAR and WE interventions represent promising tools for equipping medical students with essential BBN communication skills and are well‐suited for integration into already time‐constrained medical curricula. Breaking bad news is challenging; stress makes it harder. This research shows the value of stress arousal training and worked examples for helping to teach essential verbal and nonverbal communication skills.
      pubtype: Academic Journal
      doctype:
        cartoon
        research
        tables/charts
        randomized controlled trial
        Journal Article
      ougenre: Article
    language: English
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