Teaching students to break bad news

Background: Physicians typically learn to communicate bad news to patients through trial and error or observation of more senior physicians. To give m edical students initial instruction and experience in this area, we develop ed two standardized patient instructor (SPI) experiences in "breaking bad n ews." Methods: Twenty-one junior medical students had an SPI experience discussin g a new diagnosis of rectal cancer or pregancy loss. These 21 students, and 17 students having neither experience, interviewed the pregnancy loss SPI on the clinical performance examination (CPE) at the end of the junior year . Results: Students who had previously had a "breaking bad news" SPI experien ce performed significantly better on the CPE pregnancy loss station than st udents without this experience. There was no significant difference in perf ormance between students who had previously had the pregnancy loss versus r ectal cancer SPI. Conclusions: This research provides evidence for the effectiveness of bad n ews communication skills teaching, and its potential for transfer across co ntent areas. (C) 2001 Excerpta Medica, Inc. All rights reserved.