Abstract
Breaking bad news is inevitable for prospective doctors, it is important for medical students to learn how tohumanely communicate devastating news to parents. This study explores the discourse strategies used byChinese medical students when conducting critical conversations via role-play scenarios.
Fifty Year-6 medical students attending the ‘Serious Illness Communication Module’ were recruited from alocal medical school in Hong Kong. They were asked to participate voluntarily in two role-play scenariosrequiring them to break bad news to a simulated patient in Cantonese. The verbal interactions were video-recorded and analysed using an ethnographic discourse approach to unpack the quality of the observedinteraction sequences and identify the discourse strategies strategically used by the medical students toovercome any communication breakdowns (e.g. linguistic expressions conveying diagnoses) and showempathy to patients.
Six discourse strategies for delivering bad news were identified in the Chinese context: (1) placing greatemphasis on patients’ emotional needs; (2) informing patients with a balanced focus on medical andemotional needs; (3) directing patients’ attention to treatment options; (4) acknowledging concerns aboutdying patients’ physical discomfort and wishes; (5) directing bad news disclosure to patients; and (6)addressing the family expectations of patients. The majority of the Chinese medical students in this studyused a patient-oriented approach to cater to the patients’ emotional and physical needs. They also ofteninformed and acknowledged the patients’ family members.
When delivering bad news, medical students should be equipped with discourse strategies that effectively balance interpersonal communication with the communication of medical expertise, which is integral to ensuring patients’ participation, their understanding and satisfaction with their clinicians. However, some students demonstrated poor sensitivity to non-verbal cues, such as tone, manners and attitude. Thus, more training using a culturally appropriate model of communication for critical conversation should be promoted.
Fifty Year-6 medical students attending the ‘Serious Illness Communication Module’ were recruited from alocal medical school in Hong Kong. They were asked to participate voluntarily in two role-play scenariosrequiring them to break bad news to a simulated patient in Cantonese. The verbal interactions were video-recorded and analysed using an ethnographic discourse approach to unpack the quality of the observedinteraction sequences and identify the discourse strategies strategically used by the medical students toovercome any communication breakdowns (e.g. linguistic expressions conveying diagnoses) and showempathy to patients.
Six discourse strategies for delivering bad news were identified in the Chinese context: (1) placing greatemphasis on patients’ emotional needs; (2) informing patients with a balanced focus on medical andemotional needs; (3) directing patients’ attention to treatment options; (4) acknowledging concerns aboutdying patients’ physical discomfort and wishes; (5) directing bad news disclosure to patients; and (6)addressing the family expectations of patients. The majority of the Chinese medical students in this studyused a patient-oriented approach to cater to the patients’ emotional and physical needs. They also ofteninformed and acknowledged the patients’ family members.
When delivering bad news, medical students should be equipped with discourse strategies that effectively balance interpersonal communication with the communication of medical expertise, which is integral to ensuring patients’ participation, their understanding and satisfaction with their clinicians. However, some students demonstrated poor sensitivity to non-verbal cues, such as tone, manners and attitude. Thus, more training using a culturally appropriate model of communication for critical conversation should be promoted.
| Original language | English |
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| Publication status | Published - 27 Jun 2023 |
| Event | International Symposium on Bilingualism 14 - Macquarie University, Sydney, Australia Duration: 26 Jun 2023 → 30 Jun 2023 https://www.isb14.com https://www.isb14.com/ |
Conference
| Conference | International Symposium on Bilingualism 14 |
|---|---|
| Abbreviated title | ISB14 |
| Place | Australia |
| City | Sydney |
| Period | 26/06/23 → 30/06/23 |
| Internet address |