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MEET & MAKE CleaR PROCESS: a new framework for sharing serious information.

Etienne Rivière1,2,3, Amandine Mathé4, Thibaud Haaser5,6,7

  • 1Internal Medicine and Infectious Diseases Unit, Haut-Leveque Hospital, University Hospital Center of Bordeaux, Pessac, 33604, France. etienne.riviere@u-bordeaux.fr.

BMC Medical Education
|July 3, 2026
PubMed
Summary
This summary is machine-generated.

Physicians need better training for sharing serious information (SSI). A new framework, MEET & MAKE CleaR PROCESS, was developed using a systematic review and focus groups to improve these critical patient communication skills.

Keywords:
Breaking bad newsCognitive aidCommunicationMedical educationSharing serious informationSimulation in healthcare

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04:36

Setup and Execution of the Rapid Cycle Deliberate Practice Death Notification Curriculum

Published on: August 5, 2020

Area of Science:

  • Medical Education
  • Communication Skills
  • Patient Care

Background:

  • Sharing serious information (SSI) is a vital physician communication skill.
  • Current training and frameworks for SSI are inconsistent, leaving many physicians seeking improvement.
  • Physicians require enhanced skills to effectively deliver difficult news and manage patient expectations.

Purpose of the Study:

  • To develop a theory-informed framework and cognitive aid for sharing serious information (SSI).
  • To provide a structured approach for clinicians and educators in managing SSI encounters.
  • To enhance the quality of communication during sensitive medical discussions.

Main Methods:

  • A systematic review of four databases (1983-2024) identified core components of SSI.
  • Twelve multidisciplinary focus groups utilized the nominal group technique to integrate findings.
  • A modified PICO/PEO approach guided study selection, with 52 studies included from 4,892 initial titles.

Main Results:

  • Thematic synthesis revealed eight key themes for optimal SSI, including timely delivery, preparation, patient-centeredness, emotional support, understanding verification, treatment affirmation, offering support, and resource provision.
  • These themes informed the development of the MEET & MAKE CleaR PROCESS framework.
  • The framework includes distinct phases: preparation (MEET), sharing (MAKE), clarification (CleaR), and ongoing planning (PROCESS).

Conclusions:

  • The MEET & MAKE CleaR PROCESS framework offers a structured method for teaching and practicing SSI.
  • A cognitive aid accompanies the framework to support educators and clinicians.
  • This framework aims to reduce the adverse effects of SSI on patients, families, and physicians.