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684 How to breaking bad news: an international survey among physicians and medical students in 1146 participants
  1. J Sehouli1,2,
  2. A Pirmorady3,
  3. S Boz2,
  4. K Hasan4,5,
  5. K Pietzner1,2,
  6. E Petru6,
  7. V Heinzelmann-Schwarz7,
  8. E Roser1,
  9. D Dimitrova1 and
  10. E Herzog1
  1. 1Charité Universitätsmedizin Berlin, Klinik für Gynäkologie, Campus Virchow Klinikum, Berlin, Germany
  2. 2Noggo e.V., Nord-Ostdeutsche Gesellschaft für Gynäkologische Onkologie, Berlin, Germany
  3. 3Charité Universitätsmedizin Berlin, Medizinische Klinik mit Schwerpunkt Psychosomatik, Berlin, Germany
  4. 4MVZ Nazarethkirchstraße, Berlin, Germany
  5. 5AMBOSS GmbH, Berlin, Germany
  6. 6Univ. Klinik für Frauenheilkunde und Geburtshilfe, Medizinische Universität Graz, Klinische Abteilung für Gynäkologie, Graz, Austria
  7. 7Universitätsspital Basel, Gynäkologie/Gynäkologische Onkologie Frauenklinik, Basel, Switzerland


Introduction/Background*Delivering bad news to patients is one of the most challenging everyday tasks in medical practice. Despite its high relevance for patients, relatives, and medical staff, there is lacking data about training, experience, expectations and preferences of physicians and medical students on breaking bad news.

Methodology We therefore conducted an international survey in Germany, Switzerland and Austria using an online questionnaire among physicians and medical students. Recorded data includes demographics, physician and medical student’s clinical experience and their training and educational preferences.

Result(s)*A total of 831 physicians, including 25% gynecologists, 23.1% internal specialists and 315 medical students have participated in the survey. Physicians stated that 45,2% deliver bad news several times a week and 32.6% several times a month. Difficulties controlling their emotions was declared by 37% of the participants. The median score concerning fear was 3.5 on a scale of 0 to 10; for medical students the median score was 5.2. When delivering bad news, 70.4% of the physicians are generally alone with the patient; only 57.4% encouraging patients to be accompanied by their friends or relatives. Among the physicians, only 31.2% mentioned having learned adequate communication skills. Almost all physicians stated that communication with patients has a significant impact on their employee satisfaction. Therefore, a need for systematic training and education in breaking bad news exists. The most preferred educational tools were seminars with simulation patients (53.3%/79.3%), learning from supervisors (59.7%/64.1%) and systematic supervision (48.9%/40.4%) for physicians and medical students respectively. Digital tools may help in preparing individual sessions (54.6%) and for debriefing (38.8%) in the clinical day practice. Missing awareness (52.5%), costs (35.1%) and limited time (10.3%), were the largest barriers for communication education.

Conclusion*We could demonstrate the high need for more education and training in breaking bad news communication skills among physicians and medical students. Hospitals, authorities, medical schools and post-graduate training programs are strongly encouraged to fill this gap.

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