Final-year medical students’ experiences with breaking bad news: a qualitative study

Breaking bad news is a challenging and emotionally intense process for both patients and physicians. Experiences related to breaking bad news play a significant role in shaping medical students’ professional identity, communication skills, and ethical awareness. This study aims to explore the experiences and dilemmas encountered by final-year medical students (interns) in Türkiye during the process of breaking bad news. This qualitative study was conducted with 12 final-year medical students from a Faculty of Medicine, selected using the snowball sampling method. Data were collected through semi-structured, in-depth interviews and analyzed using thematic analysis. Participants described the process of breaking bad news as “sad and a major turning point in patients’ lives” from the patient’s perspective, and as “a source of high responsibility and stress” from the physician’s perspective. Key factors influencing the process included the patient’s prognosis and age, the family’s level of preparedness, the clinical setting, the physician’s experience, and cultural norms. Participants reported that their education on breaking bad news was insufficient, emphasizing the lack of practical training, simulation-based learning, and positive role models. Students experienced anxiety related to word choice, managing emotional responses, and ethical decision-making. The findings highlight the need to structure breaking bad news training with both theoretical and practical components, increase early clinical exposure, incorporate simulation and role-play methods, strengthen positive role models, and integrate ethical and cultural awareness into medical education. These recommendations may contribute to the improvement of medical school curricula and clinical practice.