Students in Focus – Breaking Bad News
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Background: Successful doctor-patient communication is associated with higher adherence to treatment and positive treatment outcomes. As communication skills can be learned, it makes sense to teach them within the undergraduate medical education. This study first analyzed whether students at Frankfurt medical school considered a course on “breaking bad news” to be necessary. Based on the results such a course was developed, tested in a pilot phase, implemented and evaluated over five years.Methods: An online survey was conducted with all medical students (N = 1516) to assess and analyze the demand for a course on “breaking bad news” and student preferences regarding the design of such a course. Based on the results of the survey, a new course was designed and offered five times to a total of 63 participants during a pilot run. The course was evaluated using a standardized questionnaire. The answers of the participants in the online survey were compared to those of the participants in the newly designed course. From the 2013 summer semester, the course was provided 13 times to 219 participants, and five aspects of the course were evaluated.Results: Overall, 354 students participated in the online survey (response rate 23.3 %). A considerable interest in “breaking bad news” was recognized among participants. Most students (92.5 %) responded that they would participate in a course on the subject. On a six-point Likert scale with the defined endpoints: 1 = “very confident”, 6= “not confident at all”, most students considered themselves to be “not confident” in this regard (mean value 4.2). The students’ preferences were taken into consideration in the design of the new course. The course was very well received (overall rating 1.2). In a direct comparison using pseudonyms, course participants assessed their respective own competence more highly (mean value 2.8) than they did in the online survey before the course (mean value 4.5) (n = 10). Over five years of the course’s inclusion in clinical tuition, all aspects were evaluated as “very good” (mean value 1.2).Conclusions: The online survey identified great demand for a course on “breaking bad news” at Frankfurt medical school. The increase in self-efficacy ratings after the course, measured in the pilot study, may be interpreted as an indication of value the course has for students. The new course on “breaking bad news” was designed in accordance with students’ needs and was evaluated very positively despite changing teaching staff over the five-year period. The excellent results favor the development of future teaching projects in close cooperation with students.