The hidden curriculum of breaking bad news: Identification of three dimensions and four communication patterns.

Objectives: To explore students' observations in the hidden curriculum of physicians' breaking bad news interactions and identify dimensions and patterns within them.

Methods: We qualitatively analyzed 156 written narrative descriptions of bad news encounters in the clinics written by senior medical students.

Results: The analysis identified three dimensions within the encounters: providing information, dealing with emotions, and discussing treatment plans.

The associations between reflective ability and communication skills among medical students.

Objectives: Assess associations between medical students' reflective ability demonstrated in written narratives, and communication skills demonstrated later in simulated-patient breaking bad news interactions.

Methods: We analyzed 66 medical students' reflective ability, using 'REFLECT' rubric and four newly developed parameters: Noticing Explanations provided to patients, Noticing Emotions, Remoteness/Connectedness in their writing, and mentioning Self-Emotions. 'BAS' and 'SPIKES' questionnaires measured students' communication skills.

See, reflect, learn more: qualitative analysis of breaking bad news reflective narratives.

Context: Breaking bad news (BBN) is a challenge that requires multiple professional competencies. BBN teaching often includes didactic and group role-playing sessions. Both are useful and important, but exclude another critical component of students' learning: day-to-day role-model observation in the clinics.

Near-fatal myocarditis complicating typhoid fever in a traveler returning from Nepal.

We report a 27-year-old traveler who returned from Nepal suffering from typhoid fever. His disease was complicated by life-threatening myocarditis and ventricular fibrillation, a rare manifestation in travelers.