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Does emotional intelligence predict breaking bad news skills in pediatric interns? A pilot study

Research by Reed et al. (2015), in plain language

What’s this study about?

This study looks whether emotional intelligence makes junior doctors better at delivering bad news to patients.

Why did they do this study?

Being able to deliver bad news is an important part of being a doctor, but it’s a hard thing to do even for experienced doctors. Most doctors don’t deal with this until they’re a few years in, and many won’t have had proper training or much hands-on practice in delivering bad news.

Emotional intelligence seems to be one thing that helps. Emotional intelligence is someone’s ability to understand their own feelings and other people’s feelings. Emotional intelligence is what we use to get along with others – if you have more emotional intelligence you’re likely to be better at reading, understanding and reacting to your own and others’ feelings. For doctors, it’s an important skill to have in order to look after patients, communicate with others, and be professional. Emotional intelligence is considered a ‘soft skill’ along with others like self-awareness (knowing yourself) and empathy (being able to relate to others). We need these soft skills to handle different social situations, especially ones that are complicated and stressful.

Studies show that emotional intelligence helps with things like being a team leader and having less conflict at work and at home. For doctors, emotional intelligence has been linked with better doctor-patient relationships and better stress management. But, there’s not much research on how emotional intelligence helps in bad news delivery. This study wanted to look at how emotional intelligence helps junior doctors deliver bad news. The researchers expected that the doctors who had more emotional intelligence would be better at delivering bad news.

How did they do this study?

Forty junior doctors from a children’s hospital in America took part in this study. They were 32 females and 8 males, halfway through their first year of residency training. The doctors had to deliver bad news to a pretend patient in a hypothetical situation. The hypothetical situation was a young boy dying unexpectedly after being hit by a car while riding his bike. The doctors had to deliver the bad news to the boy’s grandparent. The doctors were given a score on how well they delivered the bad news based on the ‘GRIEV_ING Protocol’, which is commonly used to train emergency staff and med students. Scoring was done by two of the researchers.

To get an idea of each doctor’s level of emotional intelligence, the researchers used a test called the Emotional and Social Competence Inventory (ESCI). The ESCI has 72 items. Each item is measured on a 5 point scale from ‘never’ to ‘always’. The doctors were rated by 5-8 of their colleagues or supervisors. The researchers felt that peer-rated scores instead of self-rated scores were more relevant in terms of communicating with others.

What did they find in this study?

In general, the doctors’ scores on how well they delivered bad news was low. But, their scores on emotional intelligence were high. There weren’t any links between specific items of the ESCI test and how well the doctors’ delivered bad news.

What do these findings mean?

These findings show that first-year junior doctors probably aren’t great at delivering bad news about death. The researchers weren’t surprised, and these findings made them feel more strongly about needing to have better training in med school on delivering bad news. The researchers think that this training could also improve doctor-patient relationships. The researchers think that the scores didn’t show a link between emotional intelligence and bad news delivery because delivering bad news is such a complicated and specific task. So, to be good at delivering bad news you actually need a special set of skills, not just skills in reading and understanding emotions. It looks like we need better ways of teaching these soft skills, and doctors should have more opportunities for hands-on practice in delivering bad news.

The researchers point out that they only studied a small group of doctors who all came from the same hospital. Their findings were also only based on one hypothetical situation. Another thing to add is that the doctors’ emotional intelligence might have scored differently on tests other than the ESCI. Even though this study didn’t show a link between emotional intelligence and how well doctors deliver bad news, the researchers still think that emotional intelligence can help doctors learn the skills needed in bad news delivery. This might be helpful to know when designing training for delivering bad news.

Where can I learn more?

This blog post is based on the following study:

Reed, S., Kassis, K., Nagel, R., Verbeck, N., Mahan, J. D., & Shell, R. (2015). Does emotional intelligence predict breaking bad news skills in pediatric interns? A pilot study. Medical Education Online, 20(1), 24245. doi: 10.3402/meo.v20.24245

You can read the original research paper here:

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