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Introduction <p>Sharing 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.</p> Method <p>A 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.</p> Results <p>Thematic 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 &amp; MAKE CleaR PROCESS framework, encompassing preparation (MEET), sharing (MAKE), clarification (CleaR), and ongoing plan (PROCESS).</p> Discussion <p>The MEET &amp; 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.</p>

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MEET & MAKE CleaR PROCESS: a new framework for sharing serious information

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月3日

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  • Etienne Rivière,
  • Amandine Mathé,
  • Thibaud Haaser,
  • Jean-Arthur Micoulaud-Franchi,
  • Aurore Gonzalez,
  • Sandrine Birsan,
  • Olivier Brissaud,
  • Véronique Averous,
  • Olivier Guisset,
  • Didier Gruson,
  • Natalia Delgado-Piccoli,
  • Amandine Quivy,
  • Charlotte Domblides,
  • Igor Sibon,
  • Pierre Burbaud,
  • Alexandre Boyer

摘要

Introduction

Sharing 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.

Method

A 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.

Results

Thematic 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.