‘i never realised that doctors were into feelings too’: changing student perceptions through...

© 2003 Blackwell Publishing Ltd.

Learning in Health and Social Care

,

2

, 3, 137–146

Original article

Blackwell Publishing Ltd.

‘I never realised that doctors were into feelings too’: changing student perceptions through interprofessional education

Samantha

Cooke

BSc(Hons)

,

1

Carolyn

Chew-Graham

MD FRCGP

,

2

Caroline

Boggis

MB BS FRCR

3

&

Ann

Wakefield

PhD MSc RGN RMN RCNT RNT

Cert Ed

4

*

1

Interdisciplinary Research Development Officer, UMIST Venture Ltd, UMIST, Main Building, Granby Row, Manchester M60 1QD, UK

2

Senior Lecturer in General Practice, School of Primary Care, Medical Education Unit, The University of Manchester, Rusholme Health Centre, Walmer Street, Rusholme, Manchester M14 5NP, UK

3

Hospital Dean Undergraduate Medical Education, South Manchester University NHS Trust, Education and Research Unit, Wythenshawe Hospital, Southmoor Road, Wythenshawe, Manchester M23 9LT, UK

4

School of Nursing, Midwifery and Health Visiting, The University of Manchester, Coupland Building III, Coupland Street, Manchester M13 9PL, UK

Abstract

The National Health Service (NHS) has called for the ‘eradication of demarcation lines

between healthcare professionals’ in the UK

.

Educational institutions are therefore

striving to achieve this outcome through integrative interprofessional initiatives. This article

discusses the effects of an integrative training course for medical and nursing students

in ‘breaking bad news’ to patients. Triangulation of the qualitative methods enabled the

researchers to gather student perspectives on this experience. Data analysis revealed

that the 34 student volunteers challenged misconceptions of professional roles through this

interprofessional programme. Questionnaires demonstrated that although most students

had enrolled on the course to develop communication skills, the interprofessional

aspect of the course was one of the main educational benefits. While outcomes were

largely positive, some students were anxious about a holistic interprofessional

curriculum. Undergraduate healthcare students may need to collaborate earlier, and

for longer time-periods, to enhance professional understanding and relationships.

Keywords

breaking bad news,

communication skills,

interprofessional

education, medical and

nursing students,

professional identity

*Corresponding author. Tel. (+44) 161 275 7007; fax (+44) 161 275 7566; e-mail [email protected]

Introduction

Pre-registration training in healthcare still remains

largely segregated by profession in the United

Kingdom (UK). At one time it seemed that there

were too many hurdles to overcome in order to

make long-term interprofessional education feasible.

For example, nursing and medical courses have

different curriculum content, student numbers,

teaching practises and accreditation methods.

138 S. Cooke

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, 3, 137–146

The Department of Health (2000) has called for

the eradication of ‘demarcation lines between

staff ’, believing that this will ultimately lead to a

better healthcare service for patients. This is driving

educational institutions to overcome practical

hurdles and develop interprofessional learning

activities in healthcare.

Previous research has shown that shared learn-

ing first needs to be meaningful for students and

facilitators (Headrick, Wilcock & Batalden 1998).

It should ‘enhance motivation to collaborate by

enabling participants to have productive learning

relationships’ (Barr

et al

. 2000, p. 8). Simply sitting

students together in a lecture theatre will not achieve

this goal and may even serve to reinforce stereo-

typical perceptions (Barr 2002). Moreover, effective

learning should not be compromised by the intro-

duction of such teaching methods (Finch 2000). If

the primary goal of interprofessional education is to

increase understanding and build interprofessional

relationships, the learning environment should be

integrative and interactive for it to succeed. Students

need to be able to challenge existing misconceptions

in order to eradicate them. Such interactive learning

environments have been created using problem-based

(Brandon & Majumdar 1997; Mires

et al

. 1999) and

experiential (Reeves

et al

. 2002) learning programmes.

Healthcare educators at the University of

Manchester decided to explore interprofessional

education through communication skills teaching.

The nursing and medical undergraduate curricula

both include communication skills. Nursing students

learn communication skills through lectures and

role-play, with fellow students playing the role of

patients. Medical students develop and practise

communication skills through role-play with simu-

lated patients. As part of their communication cur-

riculum, medical students are taught the specific

skills required for breaking bad news to patients and

relatives. Within this particular programme, a

model called SPIKES (Baile

et al

. 2000), developed

for communicating with oncology patients, is used.

The aim of this interprofessional study was to enable

medical and nursing students to experience break-

ing bad news as part of an interactive programme.

For this purpose, the existing medical breaking bad

news course was re-configured to incorporate the

role of ‘the nurse’. Each scenario was designed to

include communication with patients or relatives in

conjunction with a co-professional.

The Intervention

A small steering committee, comprising medical

and nursing educators, was set up to design and

implement a learning programme suitable for

students in the closing stages of their education.

Final-year medical students and third-year nursing

students were therefore invited to participate in a

short interprofessional breaking bad news course.

After ethical approval had been obtained for the study,

students signed a consent form, which highlighted

that they were free to leave the study at any time.

Owing to the emotive nature of the subject, students

were also informed of the support mechanisms in

place. For example, they could leave their groups at

any point during the role-play or discuss personal

difficulties with a tutor if they so wished.

The course was run over two half-day sessions

and was organized so that a series of experiential

learning situations were experienced and explored.

Each session began with a plenary discussion

around communication skills and interprofessional

learning. Following this, facilitators carried out an

interprofessional front-of-house role-play, demon-

strating how to use the SPIKES model when giving

unwelcome information (Baile

et al

. 2000). The

rules of feedback were outlined for the students at

the start of the programme. Hence, students were

informed that the feedback would be organized so as

to provide positive comments first, followed by self-

reflection and exploration of alternative strategies.

During the sessions, students were allocated to

mixed disciplinary groups of between four and six

people. As part of this process, the students were

given the opportunity to practise their commun-

ication skills using specifically designed scenarios

incorporating the use of simulated patients. The

students were instructed to work together, in

doctor–nurse dyads, by adopting an approach they

felt would elicit the best outcome for recipients of

the distressing news. For some students this process

involved them trying to work out a tentative strategy

for imparting the distressing news. In contrast,

Changing student perceptions through inter-professional education 139



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however, many simply followed their instincts,

which is one of the reasons why the feedback was so

important. Therefore, in a bid to encourage students

to gain greater insight into the effects of their inter-

actions, all participants were actively encouraged to

reflect back on their communicative behaviours and

re-enact all or part of the scenario if they felt that a

different approach might have worked better. In a

bid to make this aspect of the programme meaning-

ful, this important feedback was imparted to each

student-pair from three sources: the simulated

patients; the students’ peers observing the session;

and the two facilitators (one with a nursing back-

ground and one with a medical background).

The scenarios were made more realistic through

the use of simulated patients and, through this

medium, it was hoped that students would develop

transferable communication skills. In order to

achieve this it was thought that the students should

remain in their own professional role throughout,

with no interchange of roles, the aim being to

increase awareness of the others’ role and their own

role within breaking bad news consultations.

Evaluation methods

The main aims of the evaluation were to discover

how the course worked in practice, what the

students felt were the strengths and weaknesses of

learning communication skills together, and the

implications for future collaboration. Qualitative

methods were used to evaluate the study, as they

enabled us to explore the student experiences in

greater depth. In support of this decision, it has been

noted that there is a shortage of qualitative research

in the evaluation of interprofessional interventions

(Campbell & Johnson 1999).

Thirty-four student volunteers (22 nursing and

12 medical) took part in the programme. Clearly,

there was a serious imbalance in the disciplinary

representation, as fewer medical students volun-

teered to take part compared with nursing students.

Although this was not overtly explored as part of the

evaluation, one possible reason why fewer medical

students came forward might have been because

they had completed a very similar course of ‘break-

ing bad news’ during their fourth-year studies. This

was informally substantiated during relaxed discus-

sions with the medical students between sessions. In

particular, many of the students admitted that they

had envisaged that the interprofessional breaking

bad news course would simply be a repetition of

their previous course. Nevertheless, as the discus-

sions continued, it became obvious that this was not

the case. In contrast, this was the first time that the

nursing students had been offered a communication

skills teaching course specifically focused towards

breaking bad news, although they had participated

in general communication skills teaching as an

integral part of their curriculum.

All 34 students completed questionnaires before

and after the course. Pre-course questionnaires

explored the motivation for taking part, and student

expectations and fears (see Appendix 1), while ident-

ically structured postcourse questionnaires focused

on the students’ beliefs regarding the successes and

limitations of learning together. The questionnaires

were relatively structured, but in this way encour-

aged students to write more specifically about their

perceptions of the course.

Following the final session, a focus group was

held with six medical and two nursing student

volunteers. The project research assistant undertook

the interview, which lasted 90 min. It was felt that

by having the research assistant as the interviewer,

rather than the tutors, students would be better

able to express a ‘more honest’ view of the course

and working together. The focus group was semi-

structured in nature, with questions loosely centred

on the students’ experiences of the course, working

with tutors from other disciplines, working with

simulated patients, interprofessional education as a

concept and how far the curriculum could feasibly

change to incorporate collaborative learning. In

order to increase methodological validity, the inter-

view was subsequently audio-taped and transcribed

verbatim.

In addition to the above methods, the research

assistant recorded field notes during both of the

teaching sessions, observing a different group each

week. Field notes were also taken during the tutor

reflection meetings at the end of both sessions. This

data centred on the dynamics within the small

groups, paying particular attention to how the

140 S. Cooke

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students developed working relationships and col-

laborated during the actual consultation process.

The manner in which tutors and students from

different disciplines interacted was also recorded

through observation.

Three researchers independently analysed the data

from the qualitative questionnaires, focus group

and observational field notes, in order to identify

common emerging themes. To enhance this process,

the researchers were drawn from diverse back-

grounds: general practice; nursing; and psychology.

During this process, a method of thematic analysis,

similar to that proffered by Miles & Huberman

(1994), was employed to derive the themes. The

main aim of the evaluation was therefore to look

at how the two student groups felt they worked

together during the communication exercises, in a

bid to help the researchers design more effective

interprofessional courses in the future.

The methods employed enabled triangulation of

the data, comparing findings from one set of data

with another. In addition, the data interpretation

became more robust through independent analysis

from multiple researchers. The eventual findings

were the result of discussion and comparison of

individual interpretations, thus increasing the

level of trustworthiness (DePoy & Gitlin 1994). In

designing this methodology, the researchers decided

not to use the technique of respondent validation –

obtaining comments from students about the find-

ings. As both student groups were working towards

their end-of-year/final examinations, it was felt

that to access respondent validation would have

increased the pressure on students at a time when

this would have become an added and unnecessary

burden. In addition, this method was not seen to

be necessary, given that other measures had been

taken to generate findings which were ‘true’ to the

perceptions of the students.

Findings

The data showed that the course provided a

vehicle for students to investigate their professional

roles and determine the boundaries between

them. Similarly, students felt able to challenge

misconceptions about the other profession, given

that they were actively working with the other

students and their tutors. This activity enabled the

students to ask questions and clarify their ideas

about the professions and their philosophies of

care.

The three over-arching themes derived from

independent analysis were: challenging misconcep-

tions; team work training; and maintaining profes-

sional identity. These are discussed in detail, below.

Challenging misconceptions

On being asked for anticipated difficulties with

interprofessional learning prior to the course,

students believed that stereotypes and hierarchies

were a potential problem, as illustrated by the fact

that fewer problems with interprofessional learning

were cited within the postcourse questionnaire than

had been suggested during the pre-course phase of

the study. Students found ‘not previously knowing

each other’ and not having ‘clearly defined roles and

responsibilities’ to be problematic. However, none

of the stereotypical views highlighted above were

raised at the close of the course. The comments are

therefore typical of those expressed within the

postcourse questionnaires.

From the above, it is suggested that the stereo-

typical hierarchy, previously seen to be a potential

hurdle, did not occur when the two groups of students

actually spent time learning together.

In contrast, Carpenter (1995) found that short-

term interprofessional initiatives did not signific-

antly diminish stereotypical perceptions, especially

among nursing students. However, the responses

from students in the present study indicated that

short as it was, the course did have some success in

breaking down role misconceptions:

For example, one of the nursing students had

previously held the view that his/her profession

dealt with patient emotions and, as such, this aspect

of care was not the responsibility of doctors. By

encouraging both professional groups to consider

the emotional impact of imparting unexpected or

unwanted news to patients or relatives, coupled with

the clinical knowledge needed to substantiate and

justify information, it was possible to observe that

role boundaries became less entrenched.




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During the pre-course evaluation, students

expressed their fears that the differences between

the two professions would cause problems for inter-

professional learning. This indicates that the students

saw the roles within a breaking bad news consulta-

tion, as divided. Within the focus group, the stu-

dents explained that this perception had been

consolidated through observation of professional

role models whilst in clinical practice. While observ-

ing the student role-plays, it was evident that some

of the nursing students initially felt uncertain about

their role within the breaking bad news consulta-

tion. Hence, many adopted a passive role, allowing

the medical student to control the consultation,

only stepping in once the consultation had ended, to

comfort the patient or diffuse any anger which the

consultation had generated. This type of action

reflects the stereotypical view of many nurses that

they are simply responsible for ‘picking up the

pieces’.

The dynamic outlined above was echoed in a

similar study by Farrell, Ryan & Langrick (2001),

enabling postqualified nurses and doctors from

Paediatric, Intensive Care Unit (ICU) and Accident

and Emergency settings to experience communica-

tion training in a collaborative setting. The nurses

participating in the study of Farrell

et al.

(2001) ini-

tially regarded their role as passive during breaking

bad news consultations. As with our own study,

feedback and reflective discussion demonstrated the

need for nurses to adopt a more collaborative role

within sensitive consultations. The nurses partici-

pating in the study of Farrell

et al.

(2001) began to

realize that they actually ‘coordinated’ the scenarios,

a far more critical task than merely ‘picking up the

pieces’. In the same way, from direct observations of

the nursing students in our study, we found that

they gradually seemed more comfortable interject-

ing, particularly if they felt that they could better

explain something to the patient. Where role-

playing instruction within the scenarios was less

detailed, both student groups could decide role

boundaries for themselves, rather than following

the stereotypical perception. This proved to be a

crucial learning tool, given that the students saw

their roles as being more flexible by the end of the

course.

As Hawryluck

et al

. (2002, p. S75) discovered,

during an ethnographic study of the Intensive Care

Unit team:

… learning the balance between independent and collaborative responsibilities is part of successfully developing professional integrity and negotiating the shifting tides of the team.

Although the ability to gauge involvement

through self-exploration was valuable to most of

our participants, some students commented, after

the course, that they needed further clarification of

what the two roles entailed. This comment indicated

that the students were still reluctant to leave behind

the stereotypical misconception that each role had a

designated purpose within a given context.

Nevertheless, our data demonstrated that the

students who took part were keen to increase their

awareness of the other’s training, thus helping to

challenge their stereotypical views further. For

example, during the focus group discussion, indi-

viduals shared details about their course, an

unprompted topic enabling students to see how

their training overlapped and how this could be

enhanced through shared learning opportunities.

Team work training

At the start, the Steering Committee had considered

making the interprofessional aims of the course

explicit during the plenary discussion. Instead, they

chose to leave them implicit. Data analysis revealed

that students were aware of the importance of

learning together. Following the first session, many

students asked why they had not been given the

opportunity to learn together before, as it ‘seemed

obvious’. Before the course, most students cited skills

acquisition as something they were most looking

forward to. Postcourse evaluation demonstrated

that the ‘most enjoyable feature of the course’ was its

interprofessional participation.

By the second session, distinctions between the

nursing and medical students became less obvious.

This was evident by the seating arrangements,

which gradually became more collegial. Students

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supported and guided each other through tasks and

there was an impression that they were sharing the

experience, rather than tackling it as ‘the doctor’ or

‘the nurse’. Using each other’s names during patient

introduction, and demonstrating collective respon-

sibility by the language utilized in breaking bad news,

helped to develop interprofessional relationships.

Barr

et al

. (2000, p. 8) state that interprofessional

education can ‘give rise to expectations that rela-

tions in practice with the same or other professions

will be equally productive’. Our data showed that

students could relate experience gained as part of

the programme to their future clinical practice.

During the focus group, they discussed the implica-

tions that their new insight into the other profession

would have on their clinical work. Similarly, one of

the most commonly cited ‘uses of interprofessional

training’ in the postcourse questionnaires was that

it increased confidence in preparation for future

interprofessional communication.

As the medical students had already experi-

enced the course in a uniprofessional format, it was

interesting to obtain their perspectives on the re-

configured course. Of particular interest were the

medical students’ remarks on the added realism that

nursing students had brought to the programme.

Through focus groups with medical and surgical

residents, Dosanjh, Barnes & Bhandari (2001) also

found that an interprofessional team approach to

breaking bad news training was preferred, as it

mirrored ward dynamics more closely.

Our data also showed that receiving feedback

from tutors with different professional backgrounds

was perceived to be beneficial. The students were

able to interact with cross-disciplinary tutors in

their small groups and, from this, be exposed to

‘different perspectives on care’. Observational field

data suggested that students were keen to hear about

the clinical experiences of cross-disciplinary tutors.

Therefore, the course enabled both students and

tutors to share knowledge and experience, a process

which helped to break down barriers between stu-

dents and senior practitioners. However, this pos-

itive dynamic of openness could be a result of the

pilot aspect of the study – if the course were a formal

curriculum component there would undoubtedly

be different expectations of participants.

Maintaining professional identity

The two themes discussed above demonstrate that

much of the reported experience was positive,

suggesting a need to give all students some

interprofessional learning opportunity. Neverthe-

less, Koppel

et al

. (2001) point out that there is a

tendency for the evaluation of interprofessional

education to focus only on tentative positive

findings. In a bid to counter such criticism, the

present article highlights some of the students’

ongoing doubts regarding interprofessional edu-

cation and its ability to break down professional

barriers.

The above data demonstrates that not all of the

students fully understood the reason for inter-

professional initiatives. Fallsberg & Hammar (2000)

similarly discovered that exposure to interprofes-

sional learning did not encourage all students to

work collaboratively. Through our attempt to bring

students together to learn communication skills,

we hoped ‘that distance’ could be eradicated. Per-

haps because the students in our study were at a

later stage in their course they were uneasy about

changing the traditional nature of their learning.

Nevertheless, it is argued that students should not

embark on shared learning until they have had

adequate grounding in their own disciplinary ‘culture’

(Swanson

et al

. 1998). Once ‘them and us’ attitudes

become entrenched, however, it may be more dif-

ficult to encourage change (Leaviss 2000). From this

it could be argued that negative attitudes have the

ability to threaten and undermine interprofessional

educational processes.

Although the students enjoyed the interprofes-

sional learning aspect of the course, some wanted to

maintain some ‘[professional] distance’ and acquire

the skills necessary to ‘do it’ alone. The need to train

alone was proffered by one of the medical students

and stemmed from the view that by training with

nurses, his/her ‘shortcomings’ might become trans-

parent, which was something this individual wanted

to avoid. However, in order to provide optimum

care for patients, members of the healthcare team

should be aware of each others’ genuine limitations

and capabilities, for, without this information,

stereotypical ideas and misconceptions continue to




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flourish. Interestingly, the same student who made

the remark about ‘not wanting nursing students to

know his/her shortcomings’ also commented on

his/her experience of watching a junior doctor

struggle with a clinical task that she/he had never

practised. In the example, cited by the student in

conversation, the person struggles on and did not

seek advice from others, even when they were not

sure what to do. In this case, the perception that a

newly qualified doctor should have no shortcom-

ings prohibited the individual from stating that they

were unable to perform a clinical procedure. Such

perceptions prevented the individual from being

given the appropriate support and guidance that

would have safeguarded patients from risk. There-

fore, understanding the other profession’s short-

comings, as well as their abilities, could be a crucial

aspect of shared learning as a means of enhancing

patient care.

Discussion and concluding comments

The qualitative methods employed in this study

enabled us to uncover how the medical and nursing

students felt about learning together in an highly

interactive setting. Within the data we discovered

examples of challenging professional mis-

conceptions and the development of team

working skills. Had we concentrated on

a priori

themes, we might have supported our desire to

see the course as a resounding success. By using

methodological triangulation, however, we

uncovered some reluctance for students to let go

of their professional identity. This needs to be

more fully understood if we are to progress with

interprofessional education in the future. Much of

the data, however, points to the potential for

interprofessional initiatives to eradicate professional

misconceptions and stereotypical thinking.

Methodological triangulation enabled the focus

group data to be substantiated and underpinned by

data generated via the qualitative questionnaires. In

addition, observation methods were used to sup-

port or contradict the perspectives of the students

through interviews and questionnaires. The ques-

tionnaires were structured and therefore may have,

to a certain extent, led the students (Appendix 1).

Asking for explicit successes and failures may have

implied that there had to be some. However, the stu-

dents were inclined to leave blanks where they felt

that there were no examples, fortunately more often

in the ‘limitations’ section. The structure of the

questionnaires did enable us to generate data on

particular research areas, although perhaps more

exploratory unstructured data would be beneficial if

the study were to be repeated.

Although coding was carried out individually, at

regular intervals the research team reconvened to

reach a suitable level of agreement about the themes

identified by each individual. Therefore, the analysis

was not dominated by individual opinion, but by

collective interpretation. The diverse backgrounds

of the researchers enabled us to view the data more

widely. Daly, MacDonald & Willis (1992) used a sim-

ilar, independent panel method to analyse clinical

encounters between cardiologists and their patients.

The students who participated in this study were

perhaps more motivated to collaborate than those

who did not volunteer. This is particularly true for

the medical students who had experienced the

course the previous year in a uniprofessional format

and therefore anticipated that it would be repetitive.

Through further research it would be useful to

explore the effects of interprofessional learning on

those students who were, and still are reluctant to,

participate. In addition, the representation of the

students in various data-generating methods could

be considered limiting to the generalizability of the

results. The focus group would have generated dif-

ferent data if equal numbers of nursing and medical

students had participated. The nursing students

may have felt more inhibited to offer their opinions

by the larger group of medical students, although

this was not confirmed by close analysis of the

transcription data.

Long-term comparative studies may be lacking in

the interprofessional literature (Koppel

et al

. 2001),

but to be able to initiate such projects, evidence

from smaller-scale pilots can be cumulative. In the

present study, students and tutors from different

professions were, on the whole, found to be keen to

collaborate. By doing so they learned to support

each other, came to realize the respective import-

ance of each of their roles in performing clinical

144 S. Cooke

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tasks, and broke down some of the currently held

misconceptions about doctors, namely that doctors

are not ‘into feelings’. Breaking bad news teaching

seems to be a useful medium for interprofessional

education, as shown in our study. Harden (1998)

describes interprofessional education as a means

for students to look at a subject from another pro-

fessional perspective and thus gain greater under-

standing of professional roles within that context.

Students should also use interprofessional educa-

tion to explore common ground between profes-

sional practises. In the case of our study, ‘breaking

bad news’ training clearly provided a dynamic

atmosphere in which students were able to develop

and, in some cases, challenge their own ideas about

professional roles. In this way, students were better

able to understand and make sense of the similari-

ties and differences between the professions. More

importantly, within our own study the students

were able to develop two important skills – first, the

ability to communicate sensitively with patients

and, second, learn to support, not only each other

but also members of another professional group –

both of which are crucial to modern healthcare.

Traditional healthcare education may encourage

professional misconceptions and hierarchies to

become commonplace, entrenched within the

minds of practitioners so that they are difficult to

discard. Communication between professionals

prevents contradictions in care and therefore has

potential benefit for the treatment of patients.

Nevertheless, if professionals remain distanced,

communication will be littered with suspicion and

guardedness. During this study, one of the major

learning factors for the facilitators was that many

students felt too inhibited on the ward to approach

practitioners or students from other professions.

This highlights the need for interprofessional

education in order to decrease inhibition and

foster working relationships based on trust and

respect.

Acknowledgements

The study was funded by the Learning Teaching and

Support Network Health Sciences and Practice. The

authors wish to acknowledge the enthusiasm and

commitment of all the tutors who facilitated the

programme, in particular Dr Simon Cocksedge and

Dr Heather Anderson, who devised many of the

scenarios. In addition, we would like to thank the 34

students who gave up their time to volunteer for the

programme.

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Appendix 1

Pre-course questionnaire given to all participating students

Library card Number:___________________________________________Discipline:_______________________________

INTERPROFESSIONAL BREAKING BAD NEWS

Pre-course evaluation for Students

Spring, 2002

In a continuing effort to provide worthwhile educational experiences to our students, we would like to know what you expect from

this course. The information you provide will be confidential and only reported in anonymous format. It will be used to in enrich

multiprofessional education for future students and tutors

1. In general

a)

Please list

THREE

things that you are looking forward to about taking part in the Breaking Bad News course.

• —————————————————————————————————————————————————

• —————————————————————————————————————————————————

• —————————————————————————————————————————————————

b)

Please list

THREE


• —————————————————————————————————————————————————

• —————————————————————————————————————————————————

• —————————————————————————————————————————————————

2. During this project

, you will be working with students from another preregistration health care profession.

a)

Please list

THREE


• —————————————————————————————————————————————————

• —————————————————————————————————————————————————

• —————————————————————————————————————————————————

b)

Please list

THREE


• —————————————————————————————————————————————————

• —————————————————————————————————————————————————

• —————————————————————————————————————————————————

3.

What was the main factor that influenced you decision to participate in this Breaking Bad News Course?

4. What is your experience of working with Simulated Patients during communication training? (please explain this briefly)

——————————————————————————————————————————————————

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5. How do you feel about working with Simulated Patients?

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END OF QUESTIONNAIRE

‘i never realised that doctors were into feelings too’: changing student perceptions through...

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