Improving breaking bad news skills in chronic medical conditions: development of a formative self-assessment tool

Background: This study aims to develop an online formative self-assessment tool based on questions and messages intended for physicians to guide them in a reflection about how they break bad news. Methods: A group of psychologists and physicians worked together to analyse the literature about communication skills and the discourse of 25 patients and 22 physicians, and to develop questions and related messages about breaking bad news. The tool will then be improved both in form and in content during a pilot phase. Finally, a randomized controlled trial will be performed. Expected results: It is expected that this tool impacts: (1) professional practice and physicians’ satisfaction, (2) patients’ understanding of information, satisfaction with medical care, and psychological adjustment. Current stage at work: Currently, we have developed a set of 71 questions and related messages reviewed by a group of rheumatologists concerned by breaking bad news. Discussion: The pilot phase will help to analyse the impact on physician behaviour and to establish the optimal tool presentation format (number of sessions per week, duration of sessions) in order to improve physicians’ practice.