Articles: truth-disclosure.
-
Randomized Controlled Trial Observational Study
Training novice anaesthesiology trainees to speak up for patient safety.
A neat little study...
Gurus and team showed improvement in assertiveness and 'speaking up' behaviour among junior anaesthesia trainees, during a simulation workshop after exposure to a didactic session on speaking up behaviour – when compared to a control simulation group who did not receive the didactic session. (n=22)
The take-home message
There is likely benefit to explicitly discussing the issue of, and most importantly techniques for, speaking up when anaesthesia trainees witness management errors or oversights.
The one short-coming
The effects were only observed in a simulation environment, and while probably applicable to the more-consequential real world, as with much simulation research we are often dependent on surrogate markers of performance improvement.
Nonetheless, "we don't rise to the level of our expectations, we fall to the level of our training",1 right?
summary
-
This quote is usually attributed to the Greek poet Archilochus, over 2,500 years ago... though today popularised by the US Navy SEALs! (and perhaps a few medical simulation specialists 😉) ↩
-
-
Critical care medicine · Jun 2019
Randomized Controlled TrialEffect of Documenting Prognosis on the Information Provided to ICU Proxies: A Randomized Trial.
The Critical Care Choosing Wisely Task Force recommends that intensivists offer patients at high risk for death or severe functional impairment the option of pursuing care focused on comfort. We tested the a priori hypothesis that intensivists who are prompted to document patient prognosis are more likely to disclose prognosis and offer comfort-focused care. ⋯ Documenting prognosis may help intensivists disclose prognosis to ICU proxies, but in isolation, it is unlikely to change the treatment options offered during initial family meetings.
-
Randomized Controlled Trial
Internet-accessed sexually transmitted infection (e-STI) testing and results service: A randomised, single-blind, controlled trial.
Internet-accessed sexually transmitted infection testing (e-STI testing) is increasingly available as an alternative to testing in clinics. Typically this testing modality enables users to order a test kit from a virtual service (via a website or app), collect their own samples, return test samples to a laboratory, and be notified of their results by short message service (SMS) or telephone. e-STI testing is assumed to increase access to testing in comparison with face-to-face services, but the evidence is unclear. We conducted a randomised controlled trial to assess the effectiveness of an e-STI testing and results service (chlamydia, gonorrhoea, HIV, and syphilis) on STI testing uptake and STI cases diagnosed. ⋯ The e-STI testing service increased uptake of STI testing for all groups including high-risk groups. The intervention required people to attend clinic for treatment and did not reduce time to treatment. Service innovations to improve treatment rates for those diagnosed online are required and could include e-treatment and postal treatment services. e-STI testing services require long-term monitoring and evaluation.
-
Rev Bras Ginecol Obstet · Oct 2017
Randomized Controlled TrialBreaking Bad News Training Program Based on Video Reviews and SPIKES Strategy: What do Perinatology Residents Think about It?
Objective Resident doctors usually face the task to communicate bad news in perinatology without any formal training. The impact on parents can be disastrous. The objective of this paper is to analyze the perception of residents regarding a training program in communicating bad news in perinatology based on video reviews and setting, perception, invitation, knowledge, emotion, and summary (SPIKES) strategy. ⋯ Three big categories emerged from residents' comments: SPIKES training effects; bad news communication in medical training; and doctors' feelings and relationship with patients. Conclusions Residents took SPIKES training as a guide to systematize the communication of bad news and to amplify perceptions of the emotional needs of the patients. They suggested the insertion of a similar training in their residency programs curricula.
-
Randomized Controlled Trial
Breaking bad news to patients with cancer: A randomized control trial of a brief communication skills training module incorporating the stories and preferences of actual patients.
This study tested the effectiveness of a brief, learner-centered, breaking bad news (BBN) communication skills training module using objective evaluation measures. ⋯ Implementation of this brief individualized training module within health education programs could lead to improved communication skills and patient care.