As habilidades de comunicação de más notícias por parte dos estudantes de medicina: uma revisão de literatura
DOI:
https://doi.org/10.11606/issn.1679-9836.v105i1e-224177Palavras-chave:
Relação médico-paciente, Revelação da verdade, Educação médicaResumo
Objetivo: analisar as habilidades dos estudantes de medicina brasileiros e estrangeiros em comunicar más notícias. Metodologia: a metodologia empregada neste estudo foi a de revisão integrativa. As buscas foram realizadas nas bases de dados PubMed e Web of Science, utilizando-se os seguintes descritores: "breaking bad news" AND ("medical student*" OR "student*" OR "medical graduate*") AND "patient*” visando englobar textos de diferentes culturas e nacionalidades. Os critérios de inclusão definidos foram artigos publicados entre 2003 e 2023, com texto completo disponível. Resultados: A análise dos 17 estudos evidenciou que a comunicação de más notícias ainda é um desafio na formação médica, sendo as simulações e treinamentos específicos as estratégias mais eficazes para desenvolver essa competência entre estudantes. Conclusão: a educação médica possui diferentes desafios e abordagens ao redor do mundo, tendo em comum a preocupação de desenvolver uma boa habilidade de comunicação nos estudantes. Além disso, conclui-se que a experiência e contato dos estudantes com pacientes, através de simulações, são de grande valor para a formação, aumentando o preparo desses aprendizes
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1. Fermino TZ, Carvalho EC. A comunicação terapêutica com pacientes em transplante de medula óssea: perfil do comportamento verbal e efeito de estratégia educativa. Cogitare Enferm. 2007;12(3):287-95. Doi: https://doi.org/10.5380/ce.v12i3.10022
2. Cousin G, Schmid Mast M, Roter DL, Hall JA. Concordance between physician communication style and patient attitudes predicts patient satisfaction. Patient Educ Couns. 2012;87(2):193-7. Doi: 10.1016/j.pec.2011.08.004
3. Brédart A, Bouleuc C, Dolbeault S. Doctor-patient communication and satisfaction with care in oncology. Curr Opin Oncol. 2005;17(4):351-4. Doi: 10.1097/01.cco.0000167734.26454.30
4. Camargo NC, Lima MG, Brietzke E, Mucci S, Góis AFT. Teaching how to deliver bad news: a systematic review. Rev Bioét. 2019;27(2):326-40. Doi: 10.1590/1983-80422019272317
5. Silva AE, Sousa PA, Ribeiro RF. Comunicação de notícias difíceis: percepção de médicos que atuam em oncologia. Rev Enferm Cent Oeste Min. 2018;8:e2482. Doi: 10.19175/recom.v7i0.2482
6. Buckman R. Breaking bad news: why is it still so difficult? BMJ. 1984;288(6430):1597-9. Doi: 10.1136/bmj.288.6430.1597
7. Orlander JD, Fincke BG, Hermanns D, Johnson GA. Medical residents' first clearly remembered experiences of giving bad news. J Gen Intern Med. 2002;17(11):825-40. Doi: 10.1046/j.1525-1497.2002.10915.x
8. Baile WF, Buckman R, Lenzi R, Glober G, Beale EA, Kudelka AP. SPIKES-A six-step protocol for delivering bad news: application to the patient with cancer. Oncologist. 2000;5(4):302-11. Doi: 10.1634/theoncologist.5-4-302
9. Skye EP, Wagenschutz H, Steiger JA, Kumagai AK. Use of Interactive Theater and Role Play to Develop Medical Students' Skills in Breaking Bad News. J Cancer Educ. 2014;29(4):704-8. Doi: 10.1007/s13187-014-0641-y
10. Kiluk JV, Dessureault S, Quinn G. Teaching Medical Students How to Break Bad News with Standardized Patients. J Cancer Educ. 2012;27(2):277-80. Doi: 10.1007/s13187-012-0312-9
11. Silveira RCCP, Galvão CM. O cuidado de enfermagem e o cateter de Hickman: a busca de evidências. Acta Paul Enferm. 2005;18(3):276-84.
12. Souza MT, Silva MD, Carvalho R. Integrative review: what is it? How to do it? Einstein (Sao Paulo). 2010;8(1):102-6. Doi: 10.1590/S1679-45082010RW1134
13. Pun J. A study of Chinese medical students' communication pattern in delivering bad news: an ethnographic discourse analysis approach. BMC Med Educ. 2021;21(1):286. Doi: 10.1186/s12909-021-02724-6
14. Leppert W, Majkowicz M, Forycka M. Attitudes of Polish Physicians and Medical Students toward Breaking Bad News, Euthanasia and Morphine Administration in Cancer Patients. J Cancer Educ. 2013;28(4):603-10. Doi: 10.1007/s13187-013-0553-2
15. Gorniewicz J, Floyd M, Krishnan K, Bishop TW, Tudiver F, Lang F. Breaking bad news to patients with cancer: A randomized control trial of a brief communication skills training module incorporating the stories and preferences of actual patients. Patient Educ Couns. 2017;100(4):655-66. Doi: 10.1016/j.pec.2016.11.008
16. Alshami A, Douedi S, Avila-Ariyoshi A, Alami B, Alsaati A, Costanzo EJ, et al. Breaking Bad News, a Pertinent Yet Still an Overlooked Skill: An International Survey Study. Healthcare (Basel). 2020;8(4):501. Doi: 10.3390/healthcare8040501
17. Salam A, Zakaria H, Abdelhalim AT, Almutairi O, Alshehri A, Alfaraj S, et al. Communication Skills of Fresh Medical Graduates in a Malaysian Private University. Bangladesh J Med Sci. 2022;21(2):404-12. Doi: https://doi.org/10.3329/bjms.v21i2.58074
18. Reed S, Kassis K, Nagel R, Verbeck N, Mahan JD, Shell R. Does emotional intelligence predict breaking bad news skills in pediatric interns? A pilot study. Med Educ Online. 2015;20:24245. Doi: 10.3402/meo.v20.24245
19. Hurst SA, Baroffio A, Ummel M, Layat Burn C. Helping medical students to acquire a deeper understanding of truth-telling. Med Educ Online. 2015;20:28133. Doi: 10.3402/meo.v20.28133
20. Bukowski H, Sweeney C, Bennett D, Rizzo G, O'Tuathaigh CMP. Medical student empathy and breaking bad news communication in a simulated consultation. Patient Educ Couns. 2022;105(5):1342-5. Doi: 10.1016/j.pec.2021.09.017
21. Stiefel F, Bourquin C, Layat C, Vadot S, Bonvin R, Berney A. Medical Students' Skills and Needs for Training in Breaking Bad News. J Cancer Educ. 2013;28(1):187-91. Doi: 10.1007/s13187-012-0420-6
22. Ciałkowska-Rysz A, Dzierżanowski T. Personal fear of death affects the proper process of breaking bad news. Arch Med Sci. 2013;9(1):127-31. Doi: 10.5114/aoms.2013.33353
23. Staudt D, Stankiewicz C, Dingfield LE. Concerning Confidence: Serious Illness Conversations During the Medicine Acting Internship. Palliat Med Rep. 2022;3(1):21-5. Doi: 10.1089/pmr.2021.0065
24. Swinfen D, Labuschagne M, Joubert G. Student review of doctor-patient communication skills training in a South African undergraduate medical programme. Afr J Health Prof Educ. 2022;14(3):115-21. Doi: https://doi.org/10.7196/AJHPE.2022.v14i3.1570
25. Wouda JC, van de Wiel HBM. The communication competency of medical students, residents and consultants. Patient Educ Couns. 2012;86(1):57-62. Doi: 10.1016/j.pec.2011.03.011
26. Meitar D, Karnieli-Miller O, Eidelman S. The Impact of Senior Medical Studentsʼ Personal Difficulties on Their Communication Patterns in Breaking Bad News. Acad Med. 2009;84(11):1582-94. Doi: 10.1097/ACM.0b013e3181bb2b94
27. Setubal MSV, Antonio MÂRGM, Amaral EM, Boulet J. Improving Perinatology Residents' Skills in Breaking Bad News: A Randomized Intervention Study. Rev Bras Ginecol Obstet. 2018;40(3):137-46. Doi: 10.1055/s-0037-1621741
28. Villela EFM, Bastos LK, Almeida WS, Oliveira JC, Almeida LCG, Silva ATC, et al. Effects on Medical Students of Longitudinal Small-Group Learning about Breaking Bad News. Perm J. 2020;24:19.157. Doi: 10.7812/TPP/19.157
29. Cohen LG, Sherif YA. Twelve tips on teaching and learning humanism in medical education. Med Teach. 2014;36(8):680-4. Doi: 10.3109/0142159X.2014.916779
30. Warrier V, Pradhan A. A Narrative Review of Interventions to Teach Medical Students How to Break Bad News. Med Sci Educ. 2020;30(3):1299-312. Doi: 10.1007/s40670-020-01015-x
31. Shaw J, Brown R, Dunn S. The impact of delivery style on doctors' experience of stress during simulated bad news consultations. Patient Educ Couns. 2015;98(10):1255-9. Doi: 10.1016/j.pec.2015.08.023
32. Dale MacLaine T, Lowe N, Dale J. The use of simulation in medical student education on the topic of breaking bad news: A systematic review. Patient Educ Couns. 2021;104(11):2670-81. Doi: 10.1016/j.pec.2021.04.004
33. Porto CC. Semiologia médica. 8ª ed. Rio de Janeiro: Guanabara Koogan; 2019.
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Direitos autorais (c) 2026 Marcelo Lucas de Lima Prado, Gabriel Oliveira Teixeira Lyra, Beatriz Gabriela dos Santos Carrijo, Anna Valeska Procópio de Moura Mendonça

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