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Are you good at breaking bad news?

Wednesday 24 July, 2019

Doctor consultation

Research in the US has revealed that 91% of physicians surveyed perceived delivering bad news as a very important skill, but only 40% felt they had the training to effectively deliver such news.

You have cancer.

As a cancer patient, or when your loved one is affected, you never forgot hearing those words. Nor do you forget the way those words were delivered and by whom.

Decades of research from around the world leaves us in no doubt the benefits of effective communication between treatment teams and people with cancer. The patient’s psychosocial adjustment, decision making, treatment compliance and satisfaction with care, are all improved with good communication.

Katherine Lane, Cancer Council Victoria’s Head of Cancer Information and Support Services said cancer nurses answering calls via 13 11 20 heard stories from patients and carers all the time.

“Hearing you have cancer is a lot to take in,” Katherine says. “It’s a roller-coaster of emotions, a lot of information to absorb, all while treatment decisions are needing to be made.

“People react in a number of different ways and can go through different stages including denial and anger, bargaining, depression and acceptance.

"I just didn't feel that we had the right connections, we hadn't been told what the process was. I sat there with a stunned mind, not knowing what to ask, what to do now." - patient feedback.

“It’s also important to remember, the diagnosis is just the start, it’s a long-term relationship with your treatment team that involves a number of difficult discussions and so it’s important to get off on the right foot.

"It is important for clinicians to understand that the way in which news of any kind is delivered can have a significant impact on the patient and their families, and the decisions they may go on to make.”

Difficult for everyone involved

Breaking bad news to people with cancer is an integral role for health professionals and can be one of the most difficult roles they must perform.

Meg Chiswell, Deputy Director, Centre for Organisational Change in Person-Centred Healthcare at Deakin University’s Faculty of Health said despite this, only a small percentage of medical training was dedicated to clinical consultation skills.

“Breaking bad news is a complex communication task and it is important for clinicians that they’re able to develop the skills for this task in well-designed training programs,” Ms Chiswell said.

“Clinicians need to be able to determine the patient’s understanding of their situation and assess their wishes for participation in decision making. Conveying information in a way that is understood and identifying and responding to emotional concerns is key.”

"He had a biopsy a week after diagnosis and then about four days after that the oncologist came to talk to us and said basically there was nothing they could do. We just sat in this ward trying to absorb that news." - patient feedback.

Research by the American Society of Clinical Oncology reported that good interpersonal skills were not a substitute for strong health care communication skills. Well-designed training programs can improve clinicians’ communication skills and patient experience.

Start your training today

Given the growing emphasis and need for improved communication skills, Cancer Council Victoria has partnered with Deakin University and the Centre for Organisational Change in Person-Centred Healthcare to conduct a three-day intensive retreat for oncology and palliative care clinicians.

With a focus on implementing evidenced-based techniques and delivered by expert clinicians, this retreat is tailored to specifically address each attendee’s individual communication challenges from their own clinical practices.

The Clinical Consultation Skills Retreat 2019 will be held on October 20-23 at RACV Torquay Resort. The retreat is an RACGP and ACRRM accredited activity.

Register today



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