Stimulating reflective practice using collaborative reflective training in breaking bad news simulations.

Abstract

Medical simulation has long been used as a way to immerse trainees in realistic practice scenarios to help them consolidate their formal medical knowledge and develop teamwork, communication, and technical skills. Debriefing is regarded as a critical aspect of simulation training. With a skilled debriefing facilitator, trainees are able to go beyond a rote review of the skills and steps taken to explore their internal process and self-reflect on how their experience during the simulation shaped their decision making and behavior. However, the sense of vulnerability is an aspect of experiential training that can raise a trainee's defensiveness. Anxiety increases when trainees anticipate being evaluated for their performance, or when the simulation scenario pertains to complex interpersonal activities such as learning how to break bad news (BBN), a commonly encountered aspect of medical practice with inadequate training. Thus, collaborative reflective training (CRT), developed out of ideas based in family therapy, was designed as an approach for facilitating open dialogue and greater self-reflection while receiving training in BBN. This article will discuss the conceptual framework of CRT, explain how it was developed, and describe the nature of how it was used with a team of neonatology and pediatric fellows and medical family therapy interns. (PsycINFO Database Record

Improving Perinatology Residents' Skills in Breaking Bad News: A Randomized Intervention Study

“…The fact that both groups had the baseline SP's feedback may have contributed to the improvement of all residents' performances in the second encounter, leading to a similar final performance to both groups, shadowing the benefits of the SPIKES training session. Kim et al 40 described the difficulties to communicate with parents with whom residents had no prior contact. In their study, they created two scenarios to train perinatal residents to deliver bad news to SPs of infants with lethal diagnosis.…”

Comunicação de más notícias: do ensino médico à prática

“…No entanto, as características negativas devem ser corrigidas, para que não se perpetuem. Essa correção deve ser didática, de forma que o aluno assimile o conhecimento e não se sinta exposto diante do grupo a ponto de desistir do aprendizado 15,16 . O debriefing, método utilizado neste estudo, teve ótima aceitação dos participantes e contribuiu para o aprendizado.…”

“…Berney e colaboradores 9 recomendam uma estratégia de devolutiva individualizada 9 . Kim e colaboradores 15 apontam que o debriefing coletivo deve ter as etapas de levantamento das características do grupo, de introdução de novos conceitos e de reflexão final baseada no conteúdo assimilado. Comparando as duas estratégias, pode-se dizer que o grupo proporciona aprendizado além do que o indivíduo alcançaria isoladamente, considerando que a dificuldade de um membro pode ser a dificuldade de todo o grupo.…”

Improving the way healthcare professionals deliver different news to families during pregnancy or at birth: a qualitative study

“…This is limited because of the variation in the skills of the senior HCPs observed by junior colleagues (Kim et al, 2016;Atienza-Carrasco et al, 2018). Simulations, reflective practice, debriefing and lectures have been used to teach HCPs how to deliver different news in the paediatrics and obstetric settings (Karkowsky et al, 2016;Kim et al, 2016). A limitation of these training interventions is many have not been trialled in the UK in conjunction with minimal evidence of the transfer of skills into practice.…”