Creating COMFORT: A Communication-based model for Breaking Bad News

Abstract

This study builds upon existing protocols for breaking bad news (BBN), and offers an interaction-based approach to communicating comfort to patients and their families. The goal was to analyze medical students' (N = 21) videotaped standardized patient BBN interactions after completing an instructional unit on a commonly used BBN protocol, commonly known as SPIKES. Through post hoc interviews with the medical student, standardized patients, and faculty member for the unit, we revealed discrepancies between clinicians' idealized BBN interactions and their actual bad news delivery enactment. COMFORT, is an acronym for the seven empirically derived, resulting core communication competencies that seek to overcome some of the communicative constraints to effective BBN experienced by clinicians and patients. COMFORT is built around the fundamental principles of interaction adaptation theory (Burgoon, Stern, & Dillman, 1995), which in this case is applied to communication in medical encounters.

Keywords:

• Breaking Bad News
• Patient–Provider Communication
• Interaction Adaptation Theory
• Medical Education

Additional information

Notes on contributors

Melinda Villagran

Melinda Villagran (Ph.D., University of Oklahoma, 2001) is an Associate Professor and Director of Military Programs in Communication at George Mason University in Fairfax, VA. 4400 University Dr. MS 3D6, Fairfax VA 22030

Joy Goldsmith

Joy Goldsmith (Ph.D., University of Oklahoma, 2004) is Chair of the Department of Communication Studies at Young Harris College in Young Harris, GA

Elaine Wittenberg-Lyles

Elaine M. Wittenberg-Lyles (Ph.D., University of Oklahoma, 2004) is an Assistant Professor of Communication Studies at the University of North Texas in Denton, TX

Paula Baldwin

Paula Baldwin (M.A., Texas State University, 2009) is a Ph.D. student in the Department of Communication at George Mason University, Fairfax, VA