14 research outputs found
Recommended from our members
Interview with Sherri Greenberg on the Future of Work in Local Governments Post-Pandemic
You are viewing a news article from IBM Center For The Business of Government that was published in 2021 about Good Systems.Office of the VP for Researc
Recommended from our members
AI Ethics: Listening to Stakeholders
You are viewing a news article from Cisco Tech Blog that was published in 2021 about Good Systems.Office of the VP for Researc
Recommended from our members
Good systems, bad data?: Interpretations of AI hype andfailures
You are viewing an article from Wiley that was in the Good Systems Network Digest in October 2020.Office of the VP for Researc
Recommended from our members
Resiliency in the Age of COVID-19: A Policy Toolkit
Twenty-nine LBJ School authors have come together to craft interdisciplinary and resilience-based policy solutions in one toolkit called Resiliency in the Age of COVID-19. In 18 articles that span public management, climate change, economic development, national security and more, LBJ School policy authors provide a forward-thinking lens on what went wrong and what leadership, public policies and initiatives it will take to fix the system flaws exposed by the pandemic. Published during the LBJ School’s 50th anniversary year, the toolkit also provides a snapshot of the school’s depth and breadth of policy and research engagement at this moment in time.Public Affair
Medical Residents' First Clearly Remembered Experiences of Giving Bad News
CONTEXT: Communication of bad news to patients or families is a difficult task that requires skill and sensitivity. Little is known about doctors' formative experiences in giving bad news, what guidance they receive, or what lessons they learn in the process. OBJECTIVE: To learn the circumstances in which medical residents first delivered bad news to patients or families, the nature of their experience, and their opinions about how best to develop the needed skills. DESIGN: Confidential mailed survey. SETTING AND SUBJECTS: All medicine house officers at 2 urban, university-based residency programs in Boston. MAIN OUTCOME MEASURES: Details of medical residents' first clearly remembered experiences of giving bad news to a patient or family member; year in training; familiarity with the patient; information about any planning prior to, observation of, or discussion after their first experience; and the usefulness of such discussions. We also asked general questions about delivering bad news, such as how often this was done, as well as asking for opinions about actual and desired training. RESULTS: One hundred twenty-nine of two hundred thirteen surveys (61%) were returned. Most (73%) trainees first delivered bad news while a medical student or intern. For this first experience, most (61%) knew the patient for just hours or days. Only 59% engaged in any planning for the encounter. An attending physician was present in 6 (5%) instances, and a more-senior trainee in 14 (11%) others. Sixty-five percent of subjects debriefed with at least 1 other person after the encounter, frequently with a lesser-trained physician or a member of their own family. Debriefing focused on the reaction of those who were given the bad news and the reaction of the trainee. When there were discussions with more-senior physicians, before or after the encounter, these were judged to be helpful approximately 80% of the time. Most subjects had given bad news between 5 and 20 times, yet 10% had never been observed doing so. Only 81 of 128 (63%) had ever observed an attending delivering bad news, but those who did found it helpful 96% of the time. On 7-point scales, subjects rated the importance of skills in delivering bad news highly, (mean 6.8), believed such skill can be improved (mean 6.6), and thought that more guidance should be offered to them during such activity (mean 5.8). CONCLUSION: Medical students and residents frequently deliver bad news to patients and families. This responsibility begins early in training. In spite of their inexperience, many do not appear to receive adequate guidance or support during their earliest formative experiences