Breaking Bad News to Patients on the Breast Imaging Service: Designing A Resident Curriculum.

Saturday, May 6, 2023

First Author(s)

JG

Julia Gerras, MD

Resident Physician
University of California Los Angeles
Los Angeles, California, United States

Co-Author(s)

DB

Daniel Bradley, MD

Attending Physician
University of California Los Angeles, United States
TC

Tiffany Chan, MD

Attending Physician
University of California Los Angeles, United States
CF

Cheryce Poon Fischer, MD

Attending Physician
University of California Los Angeles
Santa Monica, California, United States
RF

Reza Fardanesh, MD

Attending Physician
University of California Los Angeles, United States
JC

James Chalfant, MD

Assistant Clinical Professor
University of California Los Angeles, United States
NY

Nazanin Yaghmai, MD

Attending Physician
University of California Los Angeles
Santa Monica, California, United States
HM

Hannah Milch, MD

Attending Physician
University of California Los Angeles, United States
RS

Robert Suh, MD

Attending Physician
University of California Los Angeles, United States

Purpose: The purpose of our study is to determine if a curriculum comprised of standardized patient encounters and clinically driven educational videos can increase the diagnostic radiology resident’s ability and comfort level in delivering news to patients on the Breast Radiology service. Such news includes traditionally “bad” results; ie, breast biopsy recommendation, as well as “good” results; ie, reassurance of a benign finding for the anxious patient. There is currently no standardized curriculum to teach residents how to effectively communicate with patients.

Methods/Materials: The residents will complete an anonymous self-evaluation utilizing a 5-point Likert scale determining their comfort level with delivering imaging results to a patient. Each resident will undergo two standardized patient encounters representing common clinical scenarios in breast radiology. They will then be evaluated by an attending with a standardized scoring sheet utilizing the established SPIKES protocol which outlines a six-step technique on how to appropriately disclose unfavorable news to patients. All scores will be submitted electronically and anonymously. An attending will debrief with the resident, providing feedback. The resident will then watch an educational video created by the authors. They will undergo two additional standardized patient encounters and be evaluated by an attending with the same standardized scoring sheet as before. Lastly, residents will complete the same self-evaluation and a similar debrief with an attending will take place. Statistical analyses will be performed to compare pre-intervention scores based on the SPIKES protocol as well as resident self-evaluation scores.

Results: Data collection began in early December and will continue to be taken throughout the academic year. There is not enough data to make any conclusions, though by the time of this conference we will present all preliminary data.

Conclusions: We are anticipating to see a statistically significant increase in the diagnostic radiology resident's comfort and confidence level in being able to deliver bad news on the breast imaging service after standardized patient encounters and watching the educational video created in this study.