Title: Assessing themes and perspectives of caregivers and surviving spouses concerning patient-physician communication during patients' end of life.

Author: Caitlin Sebastian, MS3 Mentors: Natasha Wheaton, MD, Rebecca Bavolek, MD

Area of Concentration (Petal): Medical Education

Specialty (if any): n/a

Keywords: Breaking Bad News, Patient-physician communication, SPIKES

Background: Physicians and medical educators alike widely agree that the skill of delivering bad news is a necessity for good practitioners. In 2000, the now largely accepted SPIKES protocol for delivering bad news was published, and most medical schools incorporate it in their curriculum. However, over 40 percent of patients still express dissatisfaction with the communication they received surrounding their life-altering diagnoses. This indicates the vital need to better understand the perspectives of these patients and families to improve communication.

Few studies have been conducted to identify patient and family preferences in communication of bad news. A Canadian study surveyed 220 patients across multiple disease groups and identified five common themes not addressed by the SPIKES protocol. Another found that only 41.6% of patients surveyed expressed satisfaction with their diagnosis disclosure.

Objective: To find common themes in the experiences and perspectives of families regarding the communication from their loved ones’ physicians about their illness course and end-of-life.

To explore whether families have lingering negative feelings toward physicians based on how terminal diagnoses were communicated after their loved one's death.

To identify specific actions and communication strategies used by physicians that had a positive impact on families.

Methods: 20-30 Participants will be self-selected after responding to recruitment information posted on social media. Participants will have a single 60-90 minute recorded interview with the research team, following a script written to address common themes in the experience of receiving the bad news. The script is open-ended and asks for what was done well and where there is room for improvement. The recordings will be transcribed, de-identified, and coded for themes.

Results: Results are currently pending, the project is actively enrolling now.

Conclusions: n/a