PTU-004 Applying Clinical Frameworks And Models To Improve The Specialist Screening Practitioners (ssp) Skills When Breaking Bad News Within The Bowel Screening Wales (bsw) Programme
Bibliographic record
Abstract
Introduction Communicating a life altering diagnosis to a participant is considered to be one of the most difficult aspects of the SSP role. Research would suggest that screen detected cancers are likely to be asymptomatic and in the absence of warning signs there is little time for people to prepare for such news. Screening diagnosis often show positive appraisals with an understanding that the disease may be curable through early diagnosis. The aim of this work is to determine the skills involved when the SSP breaks bad news to the participants within the bowel screening programme in Wales. Using personal reflection, clinical frameworks and models are assessed to establish if they can be used effectively to utilise these skills in the delivery of bad news. Methods A literature review of the current research into reflection and breaking bad news was undertaken; from this a number of consultation frameworks were selected, namely: Models of Communication SPIKES (Breaking bad news) The MacMaster Technique Reflective Practice and the use of Gibbs reflective cycle Key themes were identified in terms of professional and personal responsibility, particularly around communication, during the process of breaking bad news. These were adopted into clinical practice. Using Gibbs reflective cycle, personal reflection was undertaken during this transition phase and results noted. Results Effective communication in breaking bad news demonstrating empathy and respect is vitally important, and one could argue as significant as treating the person who has a cancer diagnosis. The manner in which the information is imparted to the participant and their family can have serious consequences on their psychological morbidity and their ability to engage with the decision making processes in regard to their healthcare management. Application of the structure from the Calgary Cambridge Consultation Framework, supported by the SPIKES communication model and the MacMaster Technique, provides the necessary tools to support the participant through potentially difficult clinical consultations. Likewise, practitioners are able to manage the consultation and have a clear process to follow, allowing for respect, empathy and support for the participants; thus augmenting the quality of service provided. Conclusion It is essential that SSPs have the knowledge and skills to furnish them for effective communication skills to break bad news and to support participants and their families. Implementation of these frameworks has been found to provide the tool with which the SSP can be supported in their clinical practice and also sustain their participants when communicating a life altering diagnosis. References Buckman R, Kason Y (1992) Gibbs G (1988) Kaplan M (2010) Kurtz S, Silverman J (1996) Disclosure of Interest None Declared.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.034 | 0.047 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.003 | 0.006 |
| Scholarly communication | 0.009 | 0.005 |
| Open science | 0.003 | 0.010 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.012 | 0.003 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".