title: Breaking bad news is a teachable skill in pediatric residents: A feasibility study of an educational intervention.
abstract: OBJECTIVE
  Patients and physicians identify communication of bad news as a skill in need of improvement. Our objectives were to measure change in performance of first-year pediatric residents in the delivery of bad news after an educational intervention and to measure if changes in performance were sustained over time.
  
  
  METHODS
  Communication skills of 29 residents were assessed via videotaped standardized patient (SP) encounters at 3 time points: baseline, immediately post-intervention, and 3 months post-intervention. Educational intervention used was the previously published "GRIEV_ING Death Notification Protocol."
  
  
  RESULTS
  The intraclass correlation coefficient demonstrated substantial inter-rater agreement with the assessment tool. Performance scores significantly improved from baseline to immediate post-intervention. Performance at 3 months post-intervention showed no change in two subscales and small improvement in one subscale.
  
  
  CONCLUSIONS
  We concluded that breaking bad news is a complex and teachable skill that can be developed in pediatric residents. Improvement was sustained over time, indicating the utility of this educational intervention.
  
  
  CONCLUSIONS
  This study brings attention to the need for improved communication training, and the feasibility of an education intervention in a large training program. Further work in development of comprehensive communication curricula is necessary in pediatric graduate medical education programs.
authors.affiliation: Department of Pediatrics, The Ohio State University College of Medicine, Nationwide Children's Hospital, Columbus, USA. Electronic address: suzanne.reed@nationwidechildrens.org.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Reed
authors.affiliation: Department of Pediatrics, The Ohio State University College of Medicine, Nationwide Children's Hospital, Columbus, USA.
authors.forename: Karyn
authors.initials: K
authors.lastname: Kassis
authors.affiliation: The Ohio State University College of Medicine, Columbus, USA.
authors.forename: Rollin
authors.initials: R
authors.lastname: Nagel
authors.affiliation: The Ohio State University College of Medicine, Columbus, USA.
authors.forename: Nicole
authors.initials: N
authors.lastname: Verbeck
authors.affiliation: Department of Pediatrics, The Ohio State University College of Medicine, Nationwide Children's Hospital, Columbus, USA.
authors.forename: John D
authors.initials: JD
authors.lastname: Mahan
authors.affiliation: Department of Pediatrics, The Ohio State University College of Medicine, Nationwide Children's Hospital, Columbus, USA.
authors.forename: Richard
authors.initials: R
authors.lastname: Shell
mesh_terms: D000328:Adult; D002983:Clinical Competence; D003142:Communication; D003479:Curriculum; D004503:Education, Medical, Graduate / Q000379:methods; D004521:Educational Measurement; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007396:Internship and Residency; D008297:Male; D010372:Pediatrics / Q000193:education*; D010817:Physician-Patient Relations; D010820:Physicians; D014342:Truth Disclosure
keywords: Breaking bad news; Medical education; Pediatrics