The importance of communicating bad news in medical education

Abstract Background Effective communication between doctors and patients is crucial, especially when delivering bad news that can impact a person's present and future expectations. However, acquiring optimal skills in breaking bad news requires the incorporation of multiple professional competencies that are acquired gradually through years of training. The purpose of this study was to conduct a systematic review of existing literature on medical education programs and interventions aiming to improve communication skills and to critically evaluate the effectiveness of such training. Patients and Methods We conducted a systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, searching PubMed and Scopus databases in February 2023, using the key words “medical education,” “breaking bad news,” and “end of life communication.” Results Our search yielded 21 relevant studies, with 12 randomized studies indicating improvements in trainees found in PubMed, while four Scopus studies referred to workshops and seminars that increased participants’ confidence in various communication areas. Furthermore, eight studies referred to training courses on communication techniques that helped medical students and health professionals develop confidence in breaking bad news skills. One study utilized interactive theater and role play with professional actors to teach breaking bad news to medical students, which can be a potentially powerful tool for teaching breaking bad news during medical education. One study showed that the coronavirus disease 2019 (COVID-19) pandemic has disrupted health education due to social distancing. Conclusions Our findings suggest that training physicians at the undergraduate and postgraduate levels in communication skills for breaking bad news can be beneficial for both physicians and patients. However, limitations exist in reaching definitive conclusions. As digital learning has emerged in health-care education during the post-COVID-19 period, digital solutions have also been examined for training in the communication of bad news.