title: Ability of primary care physician's to break bad news: a performance based assessment of an educational intervention.
abstract: OBJECTIVE
  We have previously described a breaking bad news (BBN) training program for primary care physicians [Ungar L, Alperin M, Amiel GE, Beharier Z, Reis S. Breaking bad news: structured training for family medicine residents. Patient Educ Couns 2002;48:63-68]. In this paper, we present the assessment of an educational intervention aimed at improving this important skill.
  
  
  METHODS
  The assessment tool was an eight station objective structured clinical examination (OSCE) utilizing standardized patients (SPs). Intervention and control groups of 17 general practitioners (GP) each were evaluated before and after an educational intervention, or a Balint group (control).
  
  
  RESULTS
  Intervention group GPs significantly increased their average grade on the post-test as compared to the pre-test (58.5, S.D. 12.7 versus 68.4, S.D. 9.2), effect size 0.94. Improvement in the control group was minimal (pre-test 57, S.D. 10.4 versus 58.1, S.D. 9.5 for the post-test), effect size 0.23. Reliability of the OSCE was alpha = 0.81.
  
  
  CONCLUSIONS
  The performance assessment used in this study proved to be a reliable and valid tool to assess the ability of physicians to break bad news. It provided evidence of the effectiveness of the intervention.
  
  
  CONCLUSIONS
  BBN training can and should be evaluated by valid and reliable measures. SPs can serve as reliable evaluators of BBN training.
authors.affiliation: Bnai-Zion Medical Center, Department of Urology, Haifa, Israel.
authors.forename: Gilad E
authors.initials: GE
authors.lastname: Amiel
authors.forename: Lea
authors.initials: L
authors.lastname: Ungar
authors.forename: Mordechai
authors.initials: M
authors.lastname: Alperin
authors.forename: Zvi
authors.initials: Z
authors.lastname: Baharier
authors.forename: Robert
authors.initials: R
authors.lastname: Cohen
authors.forename: Shmuel
authors.initials: S
authors.lastname: Reis
mesh_terms: D000328:Adult; D004502:Education, Medical, Continuing; D005194:Family Practice / Q000193:education*; D005260:Female; D006801:Humans; D007557:Israel; D008297:Male; D008875:Middle Aged; D016544:Patient Simulation; D010817:Physician-Patient Relations; D015203:Reproducibility of Results; D016037:Single-Blind Method; D014342:Truth Disclosure