title: Hospital consultants breaking bad news with simulated patients: an analysis of communication using the Roter Interaction Analysis System.
abstract: OBJECTIVE
  To explore how experienced clinicians from wide ranging specialities deliver bad news, and to investigate the relationship between physician characteristics and patient centredness.
  
  
  METHODS
  Consultations involving 46 hospital consultants from 22 different specialties were coded using the Roter Interaction Analysis System.
  
  
  RESULTS
  Consultants mainly focussed upon providing biomedical information and did not discuss lifestyle and psychosocial issues frequently. Doctor gender, age, place of qualification, and speciality were not significantly related to patient centredness.
  
  
  CONCLUSIONS
  Hospital consultants from wide ranging specialities tend to adopt a disease-centred approach when delivering bad news. Consultant characteristics had little impact upon patient centredness. Further large-scale studies are needed to examine the effect of doctor characteristics on behaviour during breaking bad news consultations.
  
  
  CONCLUSIONS
  It is possible to observe breaking bad news encounters by video-recording interactions between clinicians and simulated patients. Future training programmes should focus on increasing patient-centred behaviours which include actively involving patients in the consultation, initiating psychosocial discussion, and providing patients with opportunities to ask questions.
authors: Health Sciences Research Institute, Warwick Medical School, University of Warwick, Coventry, UK. Laura.vail@warwick.ac.uk
authors: Laura
authors: L
authors: Vail
authors: Harbinder
authors: H
authors: Sandhu
authors: Joanne
authors: J
authors: Fisher
authors: Heather
authors: H
authors: Cooke
authors: Jeremy
authors: J
authors: Dale
authors: Mandy
authors: M
authors: Barnett
mesh_terms: D000328:Adult; D003142:Communication; D003253:Consultants / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D016544:Patient Simulation; D018802:Patient-Centered Care / Q000941:ethics; D010817:Physician-Patient Relations; D010820:Physicians; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D014342:Truth Disclosure; D014743:Videotape Recording