[High fidelity simulation training for medical oncology announcement consultation]

[ACACIAS 3: Learning about announcement consultations in the second cycle of medical studies]

INTRODUCTION

The second cycle of medical studies is a key time for developing interpersonal skills and the doctor-patient relationship. High-fidelity simulation is an initial learning option that enables learners to confront situations involving empathy.

METHODS

This is a feedback report from May 2023 on the implementation of simulation as a training tool for 2nd cycle medical students in the announcement consultation. The training consists of two parts: theoretical teaching via a digital platform with an assessment of theoretical knowledge and a practical part with a simulation session with an actress playing a standardized patient. The acquisition of skills and the reflexivity of learners are assessed by means of a pre- and post-test.

RESULTS

Twenty-nine externs took part in this project. Student satisfaction was 96 %. The feedback was very positive, both in terms of the quality of the sessions and the briefings/debriefings. Almost all the students wanted to repeat the experience. The simulation exercise was beneficial for the students in terms of the development (before vs. after) of their skills (verbal, emotional and relational) (1.05±0.25 vs. 1.22±0.19, P=0.047) and appeared to be relevant to the development of reflexivity (3.29±0.72 vs. 3.48±0.9, P=0.134).

CONCLUSION

This first published French study demonstrates the feasibility and value of training in announcing a diagnosis, combining teaching via a digital platform and high-fidelity simulation for second cycle medical students.

ACACIAS 1: The physiological and subjective impacts of high fidelity simulation of the breaking of bad news

STUDY OBJECTIVE

Breaking bad news (BN) is difficult and necessitates targeted training. To be effective, training may call for High Fidelity Simulation (HFS). This prospective study was conducted to objectively assess the impact of HFS as a tool conducive to the development of clinical competence in situations involving the delivery of bad news.

METHODS

This feasibility study was conducted from January to May 2021 and included students in medical oncology and digestive surgery. The subjective and objective impacts of HFS were evaluated by means of a self-administered questionnaire and a wristband, Affect-tag, which recorded several indicators: emotional power (EP), emotional density (DE) and cognitive load (CL) in students undergoing training.

RESULTS

Forty-six (46) students with a median age of 25 years (21-34 years) were included. While the participants were effectively and emotionally involved in the HFS training, they were not completely overwhelmed by their emotions, a possible occurrence in this type of program. After two training programs, the students presented with lower EP (P<0.001) and higher DE (P=0.005), while their CL remained stable (P=0.751). The information given in the self-administered questionnaires and the evaluations by outside professionals (actor, nurse, psychologist…) highlighted improved skills.

CONCLUSION

Taking into account the emotional parameters observed and the questionnaires collected, HFS can be considered as a suitable and effective tool in the breaking of bad news.

Teaching how to break bad news in Oncology: In-class vs. virtual peer role-plays

BACKGROUND

We report two different peer role-play training courses for breaking bad news (BBN) in Oncology, the classic "in-class" model and the "virtual" peer role-play (VPRP) model developed during the SARS-CoV-2 pandemic.

METHODS

Each session included 20-25 4th year medical students supervised by two practitioners experienced in oncology. After an ice breaking activity to exchange with students on means to promote hope to patients when BBN, peer role-plays started. Pre-and post-session questionnaires were submitted to evaluate students' satisfaction, attitudes, and perceptions. Pre-and post-session knowledge test were realized. Each student has participated to only one peer-role play either "in-class" (2018) or VPRP (2020).

RESULTS

In 2018, a total of 222 students received the "in-class" training. In 2020, a total 431 students received the VPRP training. For almost all students it was the first peer role-play training session. Before training, reported level of confidence in BBN was low. After training, students of the VPRP group were highly satisfied regarding quality (realism, organization). Students also reported great interest and perceived benefits. Students who underwent "in-class" training course showed a significantly higher improvement (+1.9 points) of their knowledge scores compared to those who underwent the VPRP training course (+0.7 points) (P-value=2e-16).

CONCLUSION

The two methods seem beneficial to improve knowledge skills in BBN although "in-class" training class seem to be more efficient. To our knowledge, this is the first comparison between virtual and in-class peer-role play training for BBN in oncology.