Authors: Horwitz, N.; Ellis, J.

Source: Child: Care, Health and Development, Volume 33, Number 5, September 2007 , pp. 625-630(6)

Publisher: Wiley-Blackwell

Abstract:

Aims 

To ascertain the level of support and training available to paediatric specialist registrars (SpRs) in breaking bad news and their self-reported confidence in this task. Study design 

A questionnaire-based survey. Participants 

Paediatric SpRs working in North Thames region. Methods 

Specialist registrars (n = 206) were sent a questionnaire relating to the level of support and training available to them in breaking bad news and their attitudes to this task. A repeat questionnaire was sent out 2 weeks later. Results 

The response rate was 54.9%. The study sample included 78 females and 34 males. The median year of qualification was 1995 [interquartile range (IQR) 1993-1997] and the median year of Calman training was Year 3 (IQR 2-4). Only 15.9% of participants had guidelines where they worked and 91.2% had received training in breaking bad news. Median self-perceived confidence in breaking bad news was rated as 4 out of 5. Only 21.2% of all respondents had both disclosed a diagnosis of Down syndrome and received feedback on their performance from their seniors. Few SpRs were able to adhere to all evidence-based recommendations for breaking bad news. Discussion 

Most SpRs had received training in breaking bad news and self-reported confidence in this skill was high, although their hands-on experience was limited. Recent research shows, however, that parental dissatisfaction with the way in which bad news is broken remains high. The potential discrepancy between self-reported confidence and actual competence casts doubt on the value of self-evaluation.

Keywords: disability; Down syndrome; medical education; self-evaluation

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1365-2214.2007.00742.x

Affiliations: 1: Department of Epidemiology and Biostatistics, Institute of Child Health, London, UK

Publication date: 2007-09-01

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