Physicians work with actors to
get better at breaking bad news
the patient is stunned, then furious. “A mistake? You made a mistake?” he thunders before
breaking down in ragged sobs. The surgeon, a
urology resident, has just told the patient that
the pathology report indicating no evidence
of prostate cancer had been misfiled in “Mr.
Smith’s” chart. The patient’s actual report
shows aggressive prostate cancer.
The surgeon is shaken and momentarily
at a loss for words. This, in spite of the fact
that the charts are fictitious and Mr. Smith is
an actor. It’s all part of the Ottawa Hospital’s
Breaking Bad News, a training program devised by Fraser Rubens,
a cardiac surgeon at the
University of Ottawa
Heart Institute and a
professor in U of O’s
faculty of medicine.
Dr. Rubens says all physicians will have
to deliver some bad news – a death, a mistake,
a surgical slip – and how they deliver that
news can affect overall patient outcomes. He
acknowledges the perception that surgeons
tend to lack empathy in their interactions
with patients and patients’ families. This led
to the idea of putting surgical residents into
scenarios with professional actors, using sto-
ries culled from patient advocacy groups and
files from the Ottawa Hospital.
Making doctors forget it’s just an exercise
is key, according to Ottawa actor John Koens-gen who has played numerous roles, including half of a pair of warring siblings dealing
with their mother’s unexpected death on the
operating table. “The doctors are not gods so
when things go wrong, they have to be able
to empathize and help people deal with the
situation,” he says.
The role-play program is among the new
ways faculty are implementing the Can-MEDS initiative created by the Royal College of Physicians and Surgeons of Canada
that focuses on seven overlapping roles of a
physician that includes being a good communicator.
“If you understand how important it is to
look someone in the eye, to get at their level,
to appropriately hold their hand, to use the
right tone of voice, you can’t help but bring
that over into day-to-day dealings with patients,” says Dr. Rubens. “Utilizing some of
those same behaviours can certainly lead to an
improvement in patient compliance and outcome, and patient satisfaction. I think every
hospital is striving for that.”– becky rynor
“When things go wrong,
doctors have to be able
to empathize and help
people deal with the
UBC umbrella sharing brightens gloomy days
Robert Proulx, recteur de l’Université du Québec à Montréal,
dans une opinion dans La Presse, le 19 octobre.
A-t-on encore besoin d’insister sur la contribution essentielle des universités à l’essor
de la société canadienne Manifestement –
et malheureusement –, il semble que le rôle
vital des universités au Canada demeure
sous-estimé, sinon carrément négligé.
call it murphy’s law of umbrellas. Carry one
around all day and you’ll never see a drop of
rain; forget it at home and you’re sure to get
soaked. For the weather-weary folks at the
University of British Columbia, an umbrella-sharing service has come to the rescue.
Founded by UBC alumni Amir Entezari
and his business partner Babak Asad along
with the university’s Alma Mater Society,
UmbraCity launched in September as a pilot
project. It borrows from the bike- and auto-sharing movements to add convenience to
our lives while considering sustainability issues – in this case, reducing the number of
broken, poor-quality umbrellas that wind up
Umbrella seekers can sign up using a
credit card which gives them access, for free,
to one of 500 durable, windproof, bright
yellow umbrellas available at strategically
placed automated kiosks. Small computer
chips keep track of who has borrowed one
and when it’s returned. If all goes well, Mr.
Entezari says his plan is to expand the project to downtown Vancouver and beyond. He
hopes to create a revenue stream by selling
ads on the umbrellas. – shawna wagman