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Educating doctors about breaking bad news: An Iranian perspective

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Abstract

Background. The breaking of bad news is a frequent and well recognized task that is performed by a variety of health professionals including medical doctors. In this article, we explore both how this topic is dealt with in medical education in Iran and also consider how this aspect of the curriculum might be enriched in the future. Methods. This article is based on research, which was undertaken using a purposively selected sample of medical course planners in Iran. Semistructured interviews were conducted with each of 10 carefully selected participants. Their interview responses were analyzed in such a way as to provide an in-depth exploration and interpretation of both their perceptions and experiences in relation to this sensitive and highly important topic. Results. Four major themes emerged from the analysis of the interview transcripts: medical paternalism, religion, training issues, and professional barriers. Conclusions. On the basis of this analysis, there appears to be an urgent need for integrating more emphasis on techniques for breaking bad news into the Iranian medical education curriculum. This curriculum could in the future place more emphasis on addressing specific religious issues, which are unique to the local culture. A number of other specific recommendations are formulated and discussed.

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References

  1. Fallowfield L, Lipkin M, Hall A. Teaching senior oncologists communication skills: results from phase I of a comprehensive longitudinal program in the United Kingdom. J Clin Oncol. 1998;16:1961–1968.

    CAS  PubMed  Google Scholar 

  2. Mueller PS. Breaking bad news to patients. The SPIKES approach can make this difficult task easier. Postgrad Med. 2002;112:15–16, 18.

    Article  PubMed  Google Scholar 

  3. Back A, Curtis J. Communicating bad news. West J Med [serial online]. 2002;17:177–180.

    Article  Google Scholar 

  4. Baile WF, Buckman R, Lenzi R, Glober G, Beale EA, Kudelka AP. SPIKES-A six-step protocol for delivering bad news: application to the patient with cancer. Oncologist. 2000;5(4):302–11.

    Article  CAS  PubMed  Google Scholar 

  5. Rosenbaum ME, Ferguson KJ, Lobas JG. Teaching medical students and residents skills for delivering bad news: a review of strategies. Acad Med. 2004;79:107–117.

    Article  PubMed  Google Scholar 

  6. Ptacek JT, Eberhardt TL. Breaking bad news. A review of the literature. JAMA. 1996;276:496–502.

    Article  CAS  PubMed  Google Scholar 

  7. Fallowfield L, Jenkins V. Communicating sad, bad, and difficult news in medicine. Lancet. 2004;363:312–319.

    Article  PubMed  Google Scholar 

  8. Dosanjh S, Barnes J, Bhandari M. Barriers to breaking bad news among medical and surgical residents. Med Educ. 2001;35:197–205.

    Article  CAS  PubMed  Google Scholar 

  9. Murphy E, Dingwall, R. Qualitative Methods and Health Policy Research. New York: Aldine De Gruyter; 2003.

    Google Scholar 

  10. Faulkner RA, Klock K, Gale JE. Qualitative research in family therapy: publication trends from 1980 to 1999. J Marital Fam Ther. 2002;28:69–74.

    Article  PubMed  Google Scholar 

  11. Polit DF, Beck CT. Nursing Research: Principles and Methods. 7th ed. Philadelphia, PA: JB Lippincott Williams & Wilkins; 2004.

    Google Scholar 

  12. Editorial. First, the bad news. CMAJ.2004;17:1.

  13. Dubé CE, LaMonica A, Boyle W, Fuller B, Burkholder GJ. Self-assessment of communication skills preparedness: adult versus pediatric skills. Ambul Pediatr. 2003;3:137–141.

    Article  PubMed  Google Scholar 

  14. Eggly S, Afonso N, Rojas G, Baker M, Cardozo L, Robertson RS. An assessment of residents’ competence in the delivery of bad news to patients. Acad Med. 1997;72:397–399.

    Article  CAS  PubMed  Google Scholar 

  15. Rappaport W, Witzke D. Education about death and dying during the clinical years of medical Schools. Surgery. 1993;113:163–165.

    CAS  PubMed  Google Scholar 

  16. Fallowfield L, Jenkins V, Farewell V, Saul J, Duffy A, Eves R. Efficacy of a cancer research UK communication skills training model for oncologists: a randomized controlled trial. Lancet. 2002;359:650–656.

    Article  PubMed  Google Scholar 

  17. Parle M, Maguire P, Heaven CM. The development of a training module to improve health professionals’ skills, self-efficacy and outcome expectancies when communicating with cancer patients. Social Sci Med. 1997;44:231–240.

    Article  CAS  Google Scholar 

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Author notes

  1. Mohsen Tavakol Phd

    Present address: Medical Sciences, University of Tehran, Educational Development Centre, Tehran, Iran

Authors and Affiliations

  1. University of Nottingham, UK

    Roger Murphy Phd

  2. Institute for Research and Planning in Higher Education, Tehran, Iran

    Sima Torabi Phd

Authors
  1. Mohsen Tavakol Phd
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  2. Roger Murphy Phd
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  3. Sima Torabi Phd
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Corresponding author

Correspondence to Mohsen Tavakol Phd.

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Tavakol, M., Murphy, R. & Torabi, S. Educating doctors about breaking bad news: An Iranian perspective. J Canc Educ 23, 260–263 (2008). https://doi.org/10.1080/08858190802235379

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  • DOI: https://doi.org/10.1080/08858190802235379

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