Competence in Breaking Bad news tasks: A curriculum review of teaching and assessment at Moi Teaching and Referral Hospital Eldoret Kenya.

Abstract

Purpose: The objectives of this study was to determine the adequacy of the medical training curriculum content and methodologies utilized in training doctors in breaking bad news tasks at MTRH. Methods: A mixed methods approach used to collect data. Qualitative data, focus group discussions and in-depth interviews; quantitative data; resident’s perception of the adequacy of the curriculum using a questionnaire. Study participants were postgraduate doctors and lecturers of communication skills. Data was collected using questionnaires and analysed in SPSS version 22, descriptive statistics and inferential statistics utilized in reporting the data. Qualitative data was analysed and presented thematically. A p-value of <_ 0.5 was set as significant for all tests. Results: Curriculum content and structure; 33% adequacy, teaching methodologies; 28.5% adequacy, Residents perception of various aspects of curriculum: helical or spiral with competence levels; n=70 (87.5%) No, 12.5% (10) yes, theoretical basis of communication skills covered n=46 (57.5%) No, 34 (42.5%) yes, breaking bad news training using task approach with task process n=51 (63.5%) No, 29 (36.25%) yes, Challenging situations in breaking bad news were addressed n=56 (70%) No, only 24 (30%) yes, Reflective approach in coping with the effects of breaking bad news 58 (72.5%) No, 22 (27.5%) yes. Conclusions: Overall, this study found that curriculum content and methodologies in breaking bad news teaching and assessment is inadequate to make resident doctors competent in this important skills