How breaking bad news has been taught in undergraduate medical education

Background Breaking bad news to patients is one of the most difficult communication tasks for physicians. Teaching how to break bad news therefore needs to begin at undergraduate level. We studied the subject with the following questions: how breaking bad news has been taught to medical students, what kind of results have been attained, and how this subject has been studied in the past.

Method Systematic review of the literature based on database searches (PubMed, Cochrane Library, ERIC and Medic) and manual searching.

Results A total of 31 articles based mainly on student questionnaires were analysed. Simulated patients were the most common learning method used. The simulation exercises were useful and individual feedback was meaningful for students. Training how to break bad news improved students’ patient-centred approach and empathy.

Conclusions How to break bad news is an important subject and the need for training is widely recognized. Opportunities to practice the skill of breaking bad news and get immediate feedback should be provided in undergraduate medical education. Simulated patients are an effective learning method. Scientific knowledge has increased in recent years but Finnish studies and follow-up studies are needed in the future.

Salla Rasmus, Marja-Leena Hyvärinen and Pekka Mäntyselkä

Salla Rasmus

M.D., B.A., Doctor in Training (Sports and Exercise Medicine)

University of Eastern Finland