Development of a training course to improve sharing bad news (SBN) skills in fertility care: the FertiCOMM

Bad news are shared every day at fertility clinics (e.g., infertility diagnosis, treatment failure) but tailored evidence-based guidance for staff is lacking. We will co-develop a training course to improve fertility staff skills in sharing bad news (SBN) with their patients: the FertiCOMM.

For each 10 women starting fertility treatment 7 receive news that their cycle failed (HFEA, 2019). Sharing bad news (SBN) is a daily occurrence in fertility care, including news of fertilization failure, recurrent miscarriage, etc.
SBN are a major challenge for patients and staff. After a failed cycle, 30% of men and 10% of women present a psychiatric disorder (e.g., depression). Patients who receive bad news experience unanticipated emotional or physical reactions (e.g., shock) and 47% express that staff could do better in SBN. Fertility staff perceive SBN as one of the biggest challenges of their job and report willingness to receive training.

Perception of insensitive care and mismanagement of psychological aspects are leading reasons why patients stop treatment and change clinics. SBN in a sensitive way is expected to result in better patient-centred-care experiences and higher patient satisfaction ratings. These are conducive to higher treatment uptake and, therefore, higher chances of conception.

Aims
1) Develop training to improve fertility staff skills in SBN: the FertiCOMM;
2) Assess the acceptability and fidelity of FertiCOMM among fertility staff and patients.

Methods
Following MRC guidance to develop complex interventions, to develop the FertiCOMM, we will conduct a Systematic Literature Review of existing SBN training and conduct Online Surveys and run Focus Groups with fertility patients and staff to assess their needs and preferences in SBN;
Results obtained will inform the co-production of FertiCOMM.
To assess FertiCOMM (RQ3) we will design and implement a small-scale feasibility stydy whereby staff from the Wales Fertility Institute will be offered the FertiCOMM training and observed using new skills while SBN with 4 patients each (N=80) one week after. We will collect data on staff’s performance while SBN and self-perceived confidence to do it (fidelity), as well as on their views of using the FertiCOMM (acceptability). Patients’ experiences of patient-centred-care and satisfaction with care will also be assessed (acceptability).

Training opportunities

This PhD programme offers candidates training in Health and Social Psychology and its practical applications into health services improvement.

The supervision team is interdisciplinary and composed of academics and field practitioners. The student will develop competences in intervention co-production (with stakeholders) and testing (according to the UK Medical Research Council guidance), use of mixed-methods designs, participatory research, patient-centred care, among others.
The programme includes training opportunities with the Cardiff Doctoral Academy and other world leading research institutions such as DECIPHER and the Centre for Trials Research.