Teaching Physicians How to Break Bad News

Abstract

THE SUDDEN and unexpected admission of a previously healthy child with a potentially fatal illness to a pediatric intensive care unit is very emotionally stressful for parents.¹ It is likewise stressful for physicians, who find it difficult to communicate this bad news to the parents.^1-4 Conveying bad news is a challenging yet important communication skill for physicians.^5,6 Besides the moral and social obligation of conveying bad news in a sensitive and accurate manner, it is also a medicolegal responsibility of the physician to inform parents of a potentially fatal diagnosis. If handled improperly, communication of bad news can generate feelings of mistrust, anger, fear, and blame. It can have adverse long-term effects in the form of emotional consequences for the family.^1,7 Despite the importance of this interaction, there are few reported formal training courses to teach residents or fellows how to convey this information.^8-10 Pediatric intensive care physicians frequently have to convey bad news to parents, yet there are no reports documenting that they receive any formal training in this area during fellowship training. We developed a 1-day workshop to train fellows in this area, with standardized parents (SPs) acting as educators and evaluating the short-term effectiveness of our intervention. To our knowledge, this is the first study to evaluate the usefulness of SPs trained in a 1-day workshop in improving the short-term performance of fellows in breaking bad news to parents.