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. Author manuscript; available in PMC: 2018 Apr 1.
Published in final edited form as: Patient Educ Couns. 2016 Nov 13;100(4):655–666. doi: 10.1016/j.pec.2016.11.008

Table 3.

Summary Comparison of BBN Communication Skills Training Incorporating OSCEs and Randomized Control Design.

Authors Training Method Participants Highlights of Significant Results
(Note: Areas of overlap between improvements in communication skills demonstrated in our study and other studies are italicized. Bracketed numbers after skill items correspond to similar skills assessed by our measures.)
Gorniewicz, Floyd, Krishnan, Bishop, Tudiver, and Lang (2016) Self-directed PowerPoint-based training module incorporating cancer patient videos (1 hour)
Total time: 1 hour		 Students (medical, nursing, and pharmacy) and Medical Residents (family medicine and internal medicine) Student group
Colon cancer OSCE:

  1. Breaking Bad News (p = .007; effect size r = -.47)

  2. Attention to Patient Responses after BBN (p < .001; r = -.74)

Breast cancer OSCE:

  1. Breaking Bad News (p = .003; r = -.53)

  2. Attention to Patient Responses after BBN (p = .001; r = -.65)

  3. Communication Related to Patient Emotions (p = .043; r = -.33)

  4. Addressing Feelings with Patient (p = .006; r = -.48)

Medical Resident group
Colon cancer OSCE

  • 1. Breaking Bad News (p = .004; r = -.43)

  • 3. Communication Related to Emotions (p = .034; r = -.30)

  • 4. Addressing Feelings with Patients (p < .001; r = -.65)

  • 5. After BBN, Determines Patient Readiness to Proceed and Communication Preferences (p = .041; r = -.28)

  • 6. Active Listening (p = .011; r = -.37)

  • 7. Closing the Interview (p = .002; r = -.48)

  • 8. Global Interview Performance (p = .001; r = -.51)
[25) Lienard, Merckaert, Libert, et al. (2010) Lecture and small groups w/ role-playing and feedback
Total time: 40 hours		 Medical Residents Open question [6] (p < .001; RR = 5.79)
Open directive questions [6] (p = .003; RR = 1.71)
Empathy [2,4] (p = .017; RR = 4.50)
Fewer medical words [1] (p < .001; RR = .74)
Less information transmission (p = .001; RR = 0.72)
[29] Szmuilowicz, el-Jawahri, Chiappetta, et. al (2010) Lecture and small groups w/ role playing and feedback
Total time: 5 hours		 Medical Residents (internal medicine PGY 2) Responding to emotion - overall score [2-4] (p = .03)
[30] Daetwyler, Cohen, Gracely, et. al (2010) doc.com online BBN module (1 hour) + WebEncounter OSCE (10 minutes) w/feedback (10 minutes)
Total time: 1.3 hours		 Medical Residents BBN skills checklist summary score [1-7] (p = .018)
[31] Merckaert, Lienard, Libert, et. al (2013) Lecture and small groups, role-playing and feedback (30 hours) + stress management training (10 hours)
Total time: 40 hours		 Medical Residents (oncology, gynecology, and others) Supportive utterances: acknowledgement [2,4] (p < .001; RR =1.58)
Open directive questions [6] (p < .001; RR =2.14)
Decrease in use of medical words by residents [1] (p < .001; RR = 0.81)
Checking questions [7] (p = .034; RR =1.66)
Decrease in procedural information utterance by residents (p < .047; RR = 0.83)
Longer “pre-delivery phase” (p < .001; RR = 3.04)
Shorter “post-delivery phase” (p < .001; RR = 0.93)
[32] Fujimori, Shirai, Asai, et. al (2014) Orientation/ice-breaker (30 minutes) + lecture w/ videos (1 hour) + small group role plays w/ discussion (8 hours) + summary session (30 minutes)
Total time: 10 hours		 Oncologists (10 years of experience on average) Not beginning bad news without preamble [1] (p < .001)
Checking to see that patient understands bad news [2,7] (p = .008)
Communicating clearly main points of bad news [1] (p = .011)
Checking questions [7] (p = .045)
Providing reassurance and addressing patient's emotions with empathic Responses [2-4,6] (p = .011)
Remaining silent out of concern for patient's feelings [2] (p = .005)
Accepting patient's expression of emotions [3] (p < .001)
Using words that soothe patient [2-4] (p = .005)
Considering how to deliver bad news (p = .001)
Setting up supportive environment for interview (p = .002)
Greeting patient cordially (p <.001)
Asking how much patient knows about his or her illness before breaking bad news (p = .024)
Checking to see whether talk is fast paced (p = .005)
Providing information on services and support (p = .002)
Explaining second opinion (p = .012)