G50 DOCTORS’ RESPONSES TO THE DISCLOSURE OF A DIAGNOSIS OF DOWN SYNDROME: WHAT IS THE LEVEL OF SUPPORT AND TRAINING AVAILABLE TO SPECIALIST REGISTRARS FOR BREAKING BAD NEWS?

N. I. Horwitz¹, J. Ellis².²Institute of Child Health, London, UK; ¹Great Ormond Street Hospital, London, UK

Background: The most common presentation of Down syndrome is the previously undiagnosed baby on the postnatal ward. Breaking bad news of the diagnosis is an important and difficult skill. Training in breaking bad news can improve confidence in this task.

Aims: To ascertain the level of support and training available to paediatric specialist registrars (SpRs) in breaking bad news and their attitudes to this task.

Study Design: A questionnaire based survey with a nested randomised controlled trial.

Participants: Paediatric SpRs working in North Thames Region.

Methods: SpRs eligible for inclusion into the study (n = 206) were sent a questionnaire with questions relating to the level of support and training available to them in breaking bad news and their attitudes to this task. They were randomised to receive either a postal questionnaire (group A; n = 97) or an email questionnaire (group B; n = 109). All participants were sent a follow up questionnaire by the same method 2 weeks later.

Results: The study sample included 78 females and 34 males. The median year of qualification was 1995 (IQR 1993–1997) and the median year of Calman training was Year 3 (IQR 2–4). Responses to the survey questions revealed that 15.9% of participants had guidelines where they worked. Over 90% had received training in breaking bad news. Median self-perceived confidence in breaking bad news was rated as 4 out of 5. Most of the participants (88.1%) who had disclosed a diagnosis of Down syndrome had felt able to ask for support from a senior colleague. Evidence based recommendations for breaking bad news were followed 71.3% of the time. The overall response rate was 55.5%. The response rate in group A was 64.9% compared with …