SynthesisBMC medical education2026
MEET & MAKE CleaR PROCESS: a new framework for sharing serious information.
Synthesis in BMC medical education, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
16 authors.
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Abstract
introductionSharing serious information (SSI) is a critical communication skill for physicians. Existing frameworks vary in their teaching and application, and many physicians desire better training. This study aimed to develop a theory-informed framework and cognitive aid for sharing serious information (SSI) through a multiphased development process involving a systematic review and expert focus groups.
methodA multiphased approach was used: (1) a systematic review of four databases (1983-2024) to identify core components of SSI; and (2) twelve multidisciplinary focus groups (2022-2024) using the nominal group technique to integrate these components into a structured framework. A modified PICO/PEO approach (Population, Exposure/Intervention, Outcomes) guided study selection, and the AMSTAR2 tool was only used for quality appraisal of systematic reviews. From 4,892 titles/abstracts, 52 were selected for inclusion.
resultsThematic synthesis identified eight themes for optimal SSI: (1) limiting delay between diagnosis and SSI, (2) preparation time for meetings, (3) patient-centered communication, (4) discussion of emotions, (5) verifying understanding, (6) affirmation of treatment options, (7) offering a confidant, and (8) providing information resources. These themes, interpreted cautiously across heterogeneous evidence sources, informed the development of the MEET & MAKE CleaR PROCESS framework, encompassing preparation (MEET), sharing (MAKE), clarification (CleaR), and ongoing plan (PROCESS). DISCUSSION: The MEET & MAKE CleaR PROCESS framework and its cognitive aid aim to equip educators and clinicians with a structured approach to instructing and managing SSI encounters especially with simulation-based education. We believe this up-to-date framework could minimize the negative impact of SSI on patients, relatives, and physicians.
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