The task of breaking bad news (BBN) may be improved by incorporating simulation with art-based teaching methods. The aim of the present study was to assess the effect of an integrating simulation with art-based teaching strategies, on fellows' performance regarding BBN, in Iran. The study was carried out using quasi-experimental methods, interrupted time series. The participants were selected from medical oncology fellows at two teaching hospitals of Tehran University of Medical Sciences (TUMS), Iran. Participants were trained through workshop, followed by engaging participants with different types of art-based teaching methods. In order to assess the effectiveness of the integrating model, fellows' performance was rated by two independent raters (standardized patients (SPs) and faculty members) using the BBN assessment checklist. This assessment tool measured seven different domains of BBN skill. Segmented regression was used to analyze the results of study. Performance of all oncology fellows (n = 19) was assessed for 228 time points during the study, by rating three time points before and three time points after the intervention by two raters. Based on SP ratings, fellows' performance scores in post-training showed significant level changes in three domains of BBN checklist (B = 1.126, F = 3.221, G = 2.241; p < 0.05). Similarly, the significant level change in fellows' score rated by faculty members in post-training was B = 1.091, F = 3.273, G = 1.724; p < 0.05. There was no significant change in trend of fellows' performance after the intervention. Our results showed that using an integrating simulation with art-based teaching strategies may help oncology fellows to improve their communication skills in different facets of BBN performance. Iranian Registry of Clinical Trials ID: IRCT2016011626039N1.

Introduction and objectives: During the last decade, in response to wide ranging changes in healthcare systems and physicians' roles, the medical curriculum has undergone some modification. To achieve high quality education, 2 strategies are suggested: (1) Community-based medical education and (2) Community-oriented medical education. During the process of curriculum planning, the planners need to identify the potential areas for improvement and to guarantee the quality of instruction. This study aimed to determine the viewpoints of medical graduates from Qazvin University of Medical Science (QUMS), Tehran, on community medicine internship and clerkship programs (CMICP) in order to assist better decision-making by policymakers.Methods: In this qualitative study, the conventional content analysis approach was employed. Data were gathered from 20 primary practitioners of QUMS through individual semi-structured interviews and focus group discussions (FGD) which were continued until data saturation occured. The interviews were transcribed and analyzed immediately after the interviews. To analyze the data, one note was employed and to analyze the qualitative data, inductive method was used. The unit of analysis was selected and labeled using an open coding system. Then, the similar open codes were categorized in subthemes and finally the subthemes were organized into the main themes. Findings: The results of data analysis identified 4 main themes including: planned curriculum, delivered curriculum, hidden curriculum and curriculum evaluation.Conclusion: Many graduates suggest that, in addition to curriculum renewal, curriculum planners should identify mediated factors in CMICP to prepare graduates to practise in healthcare settings.

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Introduction: Simulation plays an important role in integrated learning of communication skills. Communication skills are known as the heart and art of medicine. Although, designing high-impact learning experiences in simulated environments are essential elements in the process of communication training, it has encountered some challenges. Art-based education by providing ‘simulation’ of the wider experience of life as well as making creative thinking in medical students can help to overcome these issues. This article aims to develop a new model of simulation for communication skills education, the Integrated Model for Communication Skills (IMCS), by integrating the essential features of simulation and art.Materials and Methods: A review was done on the current literature of medical education, simulation model and main framework of art approach. Then, an expert panel by the use of nominal group technique (NGT) was held with medical education experts in Iran and Sweden to design, select an appropriate simulation model and approve the final model (IMCS) following some modifications.Results: IMCS is an integrated model in 3 concepts of Jeffries simulation model based on art approaches: simulation design, simulation intervention and outcome. The model used activity theory and transformative learning theory to foster outcomes of skill-based and emotional-based communication skills.Conclusion: Arts strategies could be incorporated into the simulation model. The IMCS has the potential to promote emotional and technical aspects of communication skills to make the healthcare providers as competent communicators.