Kim Lee: Problem-Based Learning (PBL) Case for Delivering Uncertain News

Abstract

Abstract To help second year medical students bridge the gap between gathering difficult information and delivering challenging news, a problem-based learning (PBL) case of a patient presenting with abdominal pain who was found to have multiple hepatic lesions of uncertain etiology was developed. It was designed to: (1) help students begin to communicate with patients about serious, sensitive and challenging topics; (2) discuss the patient's experience of learning serious news; (3) explore the physician's experience of transmitting worrisome news; and (4) identify approaches for dealing with a patient's denial, anger, fear, or despair in response to hearing bad news. Immediately following the completion of this case, students and faculty completed anonymous paper-based evaluations (N = 191). Evaluation results indicate that the case was a valuable learning experience. Of 151 students invited to rate the case, 146 completed evaluations. Of those, approximately 95% agreed or strongly agreed that they learned about communicating with patients by participating in this case. Additionally, more than 90% agreed or strongly agreed that this case was helpful for improving their knowledge and skills in giving patients uncertain or difficult news. Of 40 faculty invited to rate the case, 34 completed evaluations. Of those, more than 95% agreed or strongly agreed that this case was helpful for improving student knowledge and skills in communicating uncertain or difficult news to patients. The data indicates that providing preclerkship students authentic opportunities to practice challenging communication scenarios is important in developing optimal bedside manners. Standardized patient-based PBL cases represent one approach to learning this core clinical skill.

Keywords

• Cancer
• Primary Health Care
• Neoplasms
• Abdominal Pain
• Standardized Patient
• Problem-Based Learning