Training of medical interns in breaking bad news using DISHA protocols

Abstract

Sushil Ghanshyam Kachewar , Smita Sushil Kachewar

Background: Breaking bad news is an un pleasant task and doing it at the wrong time or at wrong place and in the wrong manner can be even worse. Moreover, this process is just as hard for the person breaking the bad news as it is for the person receiving it. Yet this important Communication Skill is seldom taught to us in our training days as an Intern. Aim: To orient the medical Interns to the concept of “Bad News” and then training them in “Breaking Bad News “ in a scientific and socially acceptable manner by using a new indigenous protocol called “DISHA”. Materials and Methods: The concept of Breaking Bad News (BBN) was first explained to the Interns. Questionnaire was used to know if they felt comfortable in BBN. They were explained the protocol for BBN by an experienced faculty with help of scenario of a patient of cancer cervix. Questionnaire was used to assess if they had understood the protocol and whether they felt comfortable in BBN post intervention. Responses from the interns were obtained on the Likert Scale of 1-5; where 1-Strongly Disagree, and 5- Strongly Agree. Student’s paired-t test was used to find and compare the mean scores in pre and post intervention phase. Results: Total 76 medical interns participated in this study, out of which 31 were females and 45 were males. Mean age of participants was 22.75 years. Overall the mean score changed from 2.20±.80 to 3.70±.57 (p<0.001). In female participants, the over the mean score changed from 2.26±.93 to 3.61±.72 (p<0.001). In male participants, the over the mean score changed from 2.16±.71 to 3.76±.57 (p<0.001). Conclusion: The change in mean score of participants in response to pre intervention as well as post intervention questionnaire pertaining to BBN using DISHA protocol was significant (p<0.001); thus emphasizing the utility of this educational intervention.