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Development of a Simulation-Based Mastery Learning Curriculum for Breaking Bad News
Julia H Vermylen1, Gordon J Wood1, Elaine R Cohen1
1Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Journal of Pain and Symptom Management
|November 26, 2018
Summary
This study developed a simulation-based mastery learning curriculum for breaking bad news (BBN) conversations. A minimum passing standard was set, identifying 30% of students needing further training to ensure communication competency.
Area of Science:
- Medical Education
- Communication Skills Training
- Patient Outcomes
Background:
- Physician communication significantly influences patient outcomes.
- Current communication skills, particularly in difficult conversations, are often suboptimal.
- There is a lack of standardized methods to validate entrustment decisions for these skills.
Purpose of the Study:
- To develop a simulation-based mastery learning (SBML) curriculum focused on breaking bad news (BBN) conversation skills.
- To establish a defensible minimum passing standard (MPS) for BBN skills to ensure consistent learner competency.
Main Methods:
- Developed an SBML curriculum for fourth-year medical students focusing on BBN.
- Created a BBN assessment tool comprising a 15-item checklist and six scaled items.
- Conducted pilot testing to evaluate skill improvement and determine the MPS.
Main Results:
- Significant improvement in students' BBN checklist performance post-curriculum (65.33% to 88.67%, P < 0.001).
- Increased likelihood of students achieving a score of at least 4 (on a 5-point scale) for scaled items post-curriculum.
- Established an MPS of 80% (12/15 checklist items, 4/5 for each scaled item), with 30% of students requiring additional training.
Conclusions:
- Successfully developed an SBML curriculum and a comprehensive assessment for BBN skills.
- Established a valid competency standard (MPS) for breaking bad news conversations.
- Future work will scale the model and evaluate its impact on patient care.
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