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Revista Brasileira de Educação Médica

Print version ISSN 0100-5502On-line version ISSN 1981-5271

Abstract

QUINT, Fernanda Cristine et al. Simulation in medical education: the process of standardized patient development for breaking bad news. Rev. Bras. Educ. Med. [online]. 2021, vol.45, n.4, e218.  Epub Oct 28, 2021. ISSN 1981-5271.  https://doi.org/10.1590/1981-5271v45.4-20210039.

Introduction:

Breaking bad news is giving medical information that adversely and negatively disrupts a patient’s expectations. This is a delicate moment in the doctor-patient relationship. Role playing with standardized patients (SP) is one method for teaching such communication skills, but it is challenging to construct scripts and scenarios that reflect reality, especially when professional actors are not used.

Objective:

To describe the construction of SP based on the students’ experience for communication skills training with other medical students.

Method:

Medical students voluntarily participated in theatrical training, and worked on developing SPs, under the supervision of medical professors and actors, for breaking bad news workshops. For the construction of the SPs, unfavorable medical diagnoses were created, establishing an emotional profile, history, instructions, progressions and possible outcomes, primary and secondary objectives, and facilitating elements of the scenes. It was exhaustively tested so that the SP presented the same reaction in different attitudes in the simulations. Participation in the workshops was open to interested medical students. The quality of the scenes was measured by the sense of reality given to the workshop participants.

Result:

Ten students aged between 19 and 26 years, from different semesters, participated in the training, the SP development and role-play workshops. Four scenes were developed: Mariana was diagnosed with HIV and revealed sexual violence (60 scenes), Caroline and Marcelo who were diagnosed with cancer and needed surgery (53 scenes), Thais received a diagnosis of androgen insensitivity and presence of male gonads (31 scenes) and Roger or Rosana with retinitis pigmentosa and progressive blindness (22 scenes). All the SPs gave a sense of reality to the different workshop participants.

Conclusion:

It was possible to develop SPs with medical students, supported by professors, with the purpose of participating in workshops to communicate bad news to other medical students who perceived, for the most part, a sense of reality in the scenes. The student actors engaged in the process and developed communication and empathy competencies; characteristics necessary for medical practice.

Keywords : Patient Simulation; Role-Playing; Breaking Bad News; Medical Education.

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