Interprofessional collaboration between health professional learners when breaking bad news: a scoping review of teaching approaches.

IF 1.5 Q3 HEALTH CARE SCIENCES & SERVICES JBI evidence synthesis Pub Date : 2024-06-01 DOI:10.11124/JBIES-22-00437
Kelly Lackie, Stephen Miller, Marion Brown, Amy Mireault, Melissa Helwig, Lorri Beatty, Leanne Picketts, Peter Stilwell, Shauna Houk
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Abstract

Objective: The objective of this scoping review was to examine teaching approaches used to teach interprofessional health professional learners how to break bad news collaboratively.

Introduction: When breaking bad news, health professionals must be equipped to deliver it skillfully and collaboratively; however, the literature shows that this skill receives little attention in program curricula. Consequently, health professionals can feel inadequately prepared to deliver bad news, which may lead to increased burnout, distress, and compassion fatigue.

Inclusion criteria: Studies that describe teaching approaches used to teach learners how to break bad news collaboratively were considered for inclusion. Studies must have included 2 or more undergraduate and/or postgraduate learners working toward a professional health or social care qualification/degree at a university or college. Studies including lay, complementary and alternative, or non-health/social care learners were excluded. Due to the primary language of the research team, only English articles were included.

Methods: The JBI 3-step process was followed for developing the search. Databases searched included MEDLINE (Ovid), CINAHL (EBSCOhost), Embase, Education Resource Complete (EBSCOhost), and Social Work Abstracts (EBSCOhost). The initial search was conducted on February 11, 2021, and was updated on May 17, 2022. Title and abstract screening and data extraction were completed by 2 independent reviewers. Disagreements were resolved through discussion or with a third reviewer. Results are presented in tabular or diagrammatic format, together with a narrative summary.

Results: Thirteen studies were included in the scoping review, with a range of methodologies and designs (pre/post surveys, qualitative, feasibility, mixed methods, cross-sectional, quality improvement, and methodological triangulation). The majority of papers were from the United States (n=8; 61.5%). All but 1 study used simulation-enhanced interprofessional education as the preferred method to teach interprofessional cohorts of learners how to break bad news. The bulk of simulations were face-to-face (n=11; 84.6%). Three studies (23.1%) were reported as high fidelity, while the remainder did not disclose fidelity. All studies that used simulation to teach students how to break bad news utilized simulated participants/patients to portray patients and/or family in the simulations. The academic level of participants varied, with the majority noted as undergraduate (n=7; 53.8%); 3 studies (23.1%) indicated a mix of undergraduate and graduate participants, 2 (15.4%) were graduate only, and 1 (7.7%) was not disclosed. There was a range of health professional programs represented by participants, with medicine and nursing equally in the majority (n=10; 76.9%).

Conclusions: Simulation-enhanced interprofessional education was the most reported teaching approach to teach interprofessional cohorts of students how to break bad news collaboratively. Inconsistencies were noted in the language used to describe bad news, use of breaking bad news and interprofessional competency frameworks, and integration of interprofessional education and simulation best practices. Further research should focus on other interprofessional approaches to teaching how to break bad news; how best to incorporate interprofessional competencies into interprofessional breaking bad news education; whether interprofessional education is enhancing collaborative breaking bad news; and whether what is learned about breaking bad news is being retained over the long-term and incorporated into practice. Future simulation-specific research should explore whether and how the Healthcare Simulation Standards of Best Practice are being implemented and whether simulation is resulting in student satisfaction and enhanced learning.

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医疗专业学习者在发布坏消息时的跨专业合作:教学方法范围综述。
目的本综述旨在研究用于教授跨专业健康专业学习者如何以协作方式发布坏消息的教学方法:在发布坏消息时,医疗卫生专业人员必须具备熟练和协作发布坏消息的能力;然而,文献显示,这项技能在课程设置中很少受到关注。因此,医护人员在传递坏消息时会感到准备不足,这可能会导致职业倦怠、痛苦和同情疲劳加剧:纳入标准:纳入的研究应考虑描述用于教导学习者如何合作发布坏消息的教学方法。研究必须包括两名或两名以上在大学或学院攻读健康或社会护理专业资格/学位的本科生和/或研究生。包括非专业、补充性和替代性或非健康/社会护理学习者的研究不在考虑之列。由于研究团队的主要语言为英语,因此只收录英语文章:方法:按照 JBI 3 步流程进行检索。检索的数据库包括 MEDLINE (Ovid)、CINAHL (EBSCOhost)、Embase、Education Resource Complete (EBSCOhost) 和 Social Work Abstracts (EBSCOhost)。首次检索于 2021 年 2 月 11 日进行,并于 2022 年 5 月 17 日更新。标题和摘要筛选以及数据提取由两名独立审稿人完成。如有异议,可通过讨论或与第三位审稿人协商解决。结果以表格或图表形式呈现,并附有叙述性摘要:13 项研究被纳入范围界定审查,研究方法和设计各不相同(事前/事后调查、定性、可行性、混合方法、横断面、质量改进和方法三角测量)。大多数论文来自美国(8 篇;61.5%)。除一项研究外,其他所有研究都将模拟强化跨专业教育作为教授跨专业学员如何打破坏消息的首选方法。大部分模拟教学都是面对面的(n=11;84.6%)。三项研究(23.1%)被报告为高保真,其余研究未披露保真度。所有使用模拟教学法教授学生如何告知坏消息的研究都使用了模拟参与者/患者,在模拟教学中扮演患者和/或家属的角色。参与者的学术水平参差不齐,大多数为本科生(7 人,占 53.8%);3 项研究(23.1%)表明参与者既有本科生也有研究生,2 项研究(15.4%)仅有研究生,1 项研究(7.7%)未披露。参与者代表了不同的卫生专业课程,其中医学和护理学同样占多数(10 人;76.9%):结论:模拟增强型跨专业教育是报告最多的教授跨专业学生如何合作发布坏消息的教学方法。在描述坏消息的语言、发布坏消息和跨专业能力框架的使用以及跨专业教育与模拟最佳实践的整合等方面存在不一致。进一步的研究应关注其他跨专业方法来教授如何发布坏消息、如何最好地将跨专业能力纳入跨专业发布坏消息教育、跨专业教育是否能加强合作发布坏消息,以及所学到的发布坏消息知识是否能长期保留并融入实践。未来针对模拟的研究应探讨是否以及如何实施《医疗保健模拟最佳实践标准》,以及模拟是否能提高学生的满意度和学习效果。
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来源期刊
JBI evidence synthesis
JBI evidence synthesis Nursing-Nursing (all)
CiteScore
4.50
自引率
3.70%
发文量
218
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