Genetic simulation for high‐stakes conversations

Abstract

Background: High-stakes conversations are frequent in Medical Genetics. News shared is often perceived as "bad" and can lead to patient hostility. Breaking bad news (BBN) is therefore a challenging clinical task for physicians and is often included as a foundational skill in medical education. The methods of teaching this skill are variable, with no widely accepted standard. We propose the use of simulation as a safe and effective training tool.Approach: Medical Genetics residents participated in a 4-week curriculum on BBN and de-escalating patient hostility and anger. The curriculum consisted of (1) a standardised patient simulation scenario requiring the disclosure of abnormal prenatal test result to a hostile patient, (2) coaching and feedback by genetic counsellors (GCs), (3) reflective exercises, and (4) workshops on de-escalation techniques.Trainees completed a postsimulation survey and postencounter reflection forms.

Exploring the impact of virtual SPIKES training on genetic counselors' confidence to deliver difficult news

“…These participants revealed that the simulation, alone, was a beneficial learning experience. In a different curriculum for medical genetics residents, standardized patient simulation scenarios and genetic counselor's feedback were viewed as beneficial educational strategies when learning how to deliver difficult news (Saleh et al, 2022). Medical residents reported that simulation promoted a safe, experiential learning space and encouraged reflection.…”