Telling the truth: medical students' progress with an ethical skill

Area of Science:

• Medical Education
• Communication Skills Training
• Medical Ethics

Background:

• Truth-telling is a complex skill vital in healthcare, particularly when breaking bad news (BBN).
• Insufficient communication skills can lead to distressing and problematic BBN delivery.
• Ethical considerations are paramount in patient communication.

Purpose of the Study:

• To assess the long-term impact of a simulated patient-based teaching intervention on medical students.
• To evaluate the integration of communication skills learning and ethical reflection on students' attitudes towards truth-telling.
• To measure changes in students' perceived competence and comfort levels in breaking bad news (BBN).

Main Methods:

• Two cohorts of medical students were followed from their third preclinical year to their fifth-year clinical rotations.
• Ethical attitudes, comfort, and competence in BBN were analyzed before and after the intervention, and during clinical rotations.
• A simulated patient-based teaching intervention was implemented, integrating communication skills and ethical reflection.

Main Results:

• Students' ethical attitudes regarding truth-telling remained consistent throughout the study.
• Perceived comfort and competence in BBN improved for initially uncomfortable or incompetent students.
• Students who were initially comfortable or competent demonstrated increased awareness of BBN complexities, leading to a decrease in perceived comfort and competence.

Conclusions:

• Simulated patient scenarios combined with communication skills practice and ethical reflection effectively maintain ethical attitudes.
• The intervention successfully developed new skills and heightened awareness of the inherent difficulties in breaking bad news.
• This approach enhances medical students' preparedness for challenging patient communication scenarios.