Doctorsʼ Stress Responses and Poor Communication Performance in Simulated Bad-News Consultations

Abstract

These results suggest that BBN was a stressful experience for doctors even in a simulated encounter, especially for those who were inexperienced and/or fatigued. Poor communication performance was related to burnout and fatigue, but not inexperience with BBN. These results likely indicate that burnout and fatigue contributed to stress and poor work performance in some doctors during the simulated BBN task.

The effect of communication skills training on residents’ physiological arousal in a breaking bad news simulated task

“…The second study found an anticipatory stress response among second year medical students to a simulated bad news consultation on cardiovascular measures (systolic blood pressure and heart rate) and subjective stress measures (globally assessed stress and state anxiety), compared with post-task measures [12]. The third study found higher cardiovascular responses in the bad news scenario Patient Education and Counseling xxx (2013) xxx-xxx relative to the good news one [9]. Perceived stress, psychological distress and poor communication were not associated with increased cardiovascular responses in the bad news scenario contrary to doctors' inexperience and fatigue.…”

“…Although reviews on BBN have insisted on the stressfulness of the BBN task, to our knowledge, only four studies until now have investigated physicians' physiological and psychological stress responses during BBN [9][10][11][12]. In the first study, medical students were randomly assigned to a bad news delivery task, a good news delivery task or a control task (reading magazines).…”

“…These heightened cardiovascular responses however were not systematically associated with subjective stress measures [9]. It is therefore essential to consider the subjective quality of responses when studying the impact of a task on physiological measures [13,14].…”

Breaking bad news of cancer diagnosis - the patient’s perspective

“…Some of the factors that can affect a doctor's ability to convey bad news are long working hours, fatigue, personal difficulties, reaction of the patient, subjective attitude such as personal fear of death. 17,18 The complex nature of the interaction can sometimes create serious miscommunications [19][20][21][22] such as patient misunderstanding about the prognosis of the illness or purpose of care. [19][20][21][22][23][24][25][26][27][28] A systematic review and analysis has demonstrated that attending a communication skills training course has a moderate effect on communication behaviour and attitudes but there is a gap in research with few studies investigating patient outcomes.…”

A Suitable Model for Breaking Bad News: Review of Recommendations

“…According to the findings from the studies assessing, interactions between patients and clinicians imply that the consequences of breaking bad news poorly can affect both the patient and the doctor involved (Baile et al, 2000;Stiefel et al, 2010;Walsh et al, 1998). Stress related to these incidents can add to burn-out, lack of job satisfaction and anxiety in doctors (Ramirez et al, 1995;Stiefel et al, 2010;Brown et al, 2009). For the patient, poorly communicated bad news can also increase their stress and anxiety, poorly adjust them to the bad news and result in poorer health outcomes (Baile et al, 2000;VandeKieft et al, 2001;Lobb et al, 1999).…”