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Purpose:
For some time, the research in organ donation has shown that
collaboration between donation specialists and physicians increases family
consents for donation. Most recently, that research has specifically pointed to
having the physician and the donation coordinator present together with the family
during the brain death conversation as a key to higher consent rates. This
workshop trains physicians to talk to families about brain death and to
transition the coordinator into the conversation to talk about organ donation.
Description:
Breaking Bad News is a one-day workshop designed for
physicians who work with patients who may be pronounced by neurological
criteria. It is based on our 25 years of teaching donation coordinators how to
talk to families about brain death, on the research on donation and on the
research on breaking bad news to patients.
The workshop was field-tested in London and York in 2005 and
has since been taught at 10 other sites in England and Scotland. As the
instruction is based largely on U.S. research
disseminated through the Breakthrough Collaborative, it can easily be adapted
to U.S.
audiences. The workshop is very interpersonal, and a uses variety of
instructional methods, including presentation, demonstration, large and small
group discussion and modeling. Enrollment is limited to 18 participants.
The entire afternoon of the workshop is devoted to
role-playing. While it was our expectation that physicians might find
role-playing in front of their peers too stressful to promote learning, that did not prove to be the case. The adjective
used by most to describe the role-playing was, “Essential.”
While the workshop is still too new to make definitive
statements about its effectiveness or to publish research on, the data compiled
from the latest round of 6 workshops presented in June, 2006, indicated the
physician participants thought the following:
▪77 % The workshop provided me new skills.
▪87 % It stimulated me to examine
my current practice.
▪83 % It was worthwhile.
▪83 % I would recommend it to colleagues.
▪61 %
I will change my pattern of
non-verbal behavior when talking to
families as a result of the workshop.
▪67 % I will probe for more
concerns before trying to answer questions.
▪61 % I will ensure the donation
specialist will receive early notification.
▪58% I
will be more likely to involve the donation specialist in the brain death conversation.
▪68% I will partner with the
donation specialist.
Workshop
Objectives:
1. Acquire familiarity with the
findings of the Potential Donor Audit (U.K. only);
2. Acquire familiarity with the Best
Practices Protocols for Organ Donation established by U.S. research;
3. Acquire familiarity with Best
Practice findings in the research on Breaking Bad News;
4. Practice verbal and non-verbal
skills consistent with all Best Practice findings, including:
5. Complete at least two Breaking Bad
News role-plays, one as a physician and one as a family member, and participate
in group debriefs.
Workshop
Support:
Large group instruction in the morning will require an
overhead projector, screen, two flip charts and pads and chairs and table space
for 18 participants. (The research in Education does not support the use of
Power Point presentations for this type of instruction.) The afternoon will
require two smaller rooms set with couches and chairs for role-playing.
Advanced
Preparation:
The most difficult part of this workshop is getting the
doctors to attend. Arrangements must be
made well in advance, commitments secured and followed up. In the U.K.,
pharmaceutical companies have provided support for sites attractive to
physicians and a late start-time (10:30
a.m.) has enhanced physician attendance.
Instructional
Materials:
During the workshop, participants will receive a set of
handouts intended to preclude the necessity to extensive note taking and to
assist them in recall.
Personnel
Costs:
Honoraria $3,000.00
US
Travel, lodging and food for two from Lexington,
KY.
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