Effectiveness of Online Teaching for Development of Resident Beliefs and Understandings: A Study on Breaking Bad News to Patients

Abstract

Purpose: Testing the efficiency of online teaching in improving resident beliefs and understandings and self perception regarding breaking bad news to patients. Method: A questionnaire sheet was administered to 50 new residents at Ainshams University teaching hospitals (age 24–26) who were in their first year training and to 50 senior residents (age 26–28) who had already received two years of training. Data was analyzed and further discussed in a focus group of eight participants. Participants attended an online video based training module on breaking bad news to patients and questionnaire was administered 6 months later and compared to the original results. Results: The respondents were 60 males and 40 females. In general, the residents who answered the survey are aware of the ethical aspects of breaking bad news to patients, and report to behave in accordance with most of the principles described in the Rabow and MacPhee model. There appeared to be a significant difference in opinions and attitudes of junior and senior residents in specific issues e.g. time needed to prepare before delivering bad news, tendency to get frustrated if the patient decided to discontinue treatment or starts attacking and blaming a colleague and finally introducing themselves to the patient before delivering the news. Residents demonstrated a significant improvement in reported capacities when delivering bad news after going through an online training module. Most of the concepts, skills and beliefs were shifted except for areas that were affected by workload or cultural beliefs. Discussion: The concepts, skills and beliefs of residents regarding delivering bad news to patients are affected by their progression into their clinical practice and by exposure to formal online training. Keywords: Ethics, Communication skills, Bad news, Outcome assessment, Online teaching