# Delivery of Difficult News Among Residents at a Tertiary Hospital In Kenya Using a Short Training Video (UNMASKES)

## TL;DR

A short training video called UNMASKES helped resident doctors in Kenya and Tanzania improve their communication when delivering difficult news to patients.

## Contribution

A 4-minute graphic video (UNMASKES) was developed and tested to train residents in sub-Saharan Africa on delivering difficult news.

## Key findings

- Residents improved in six key communication areas after using the UNMASKES video.
- Improvements included ensuring privacy, summarizing information, and following up with patients.
- Residents felt more prepared to handle patient and family emotions after the training.

## Abstract

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Background

Delivery of difficult news (DDN) remains a challenging task for even the most experienced of providers. Little has been studied about delivery of difficult news among resident physicians in sub-Saharan Africa (SSA). We developed a 4-minute, graphic video using the acronym UNMASKES to help improve delivery of difficult news between resident physicians and their patients.

Objective

To determine the impact of the UNMASKES training video in improving resident communication when delivering difficult news.

Methods

We conducted a prospective study amongst all residents at the Aga Khan University hospital in Nairobi, Kenya and Dar es Salaam, Tanzania from February to September, 2019. After completing a pretest survey, residents received a one-hour comprehensive training on delivery of difficult news using UNMASKES. A link to the UNMASKES video was provided to the residents for real-time reference. Post-test surveys were completed at 4 and 12 weeks respectively.

Results

A total of 102 (68%) residents completed the surveys. At 12 weeks, we found that residents improved in 6 key areas; notified their patients before delivering difficult news, ensured a private and quiet room, provided information in small amounts to patients and family members, provided a summary after delivery of difficult news, followed up with patients at 24-48 hours after delivering difficult news, and felt better prepared to deal with patient and family emotions when delivering difficult news.

Conclusions

UNMASKES, a 4-minutes, easily accessible, graphic video showed promising results in training our residents to foster effective communication while delivering difficult news to their patients.