Learning to Break Bad News: A Collaborative Teaching, Learning and Research Initiative
Wakefield AB, Cooke S, Cocksedge S, Boggis CRM

This paper outlines a small scale interprofessional research study involving 3rd year nursing and 5th year medical students in which a small team of medical and nursing researchers attempted to equip future health care practitioners with the skills needed to break bad news. As part of the study the students were invited to work through a series of role play scenarios with simulated as opposed to real patients or their peers, given that when peers act as role play subjects the situation seems false. Nevertheless, to let novice practitioners "loose" on real patients would have been unethical, and insensitive. Yet students and qualified practitioners alike need to be able to refine their communication skills if they are to become effective, receptive, empathic communicators particularly when with issues related to death and dying. At the outset of the study, students were asked to rate their feelings of confidence and comfort across as series of clinical situations. For example, telling patients they are dying; dealing with negative emotions such as crying/anger. Students then observed a front of house demonstration of how to break bad news. This was completed by the teaching staff demonstrating best practice. The format for giving feedback mirrored that which was used when asking the students to engage in the role plays. Hence, the teachers like the participants were given feedback by the student/educators, their peers, and the simulated patient using the SPIKES model (Baile et al. 2000). Students found this mode of teaching helped them to collaborate with other health professionals and prepared them for future practice involving palliative care patients. For this reason, it is argued that similar educational processes could be utilised equally as effectively when employed within palliative care settings.