From classroom to clinic: Addressing gaps in teaching and perceived preparedness for breaking bad news in medical education
Márcio Luiz dos Santos, Laís Michelle Cunha, Ana Julia Ferreira, Ana Paula Drummond‐Lage
Abstract
BACKGROUND: Communicating bad news (BBN) is a significant challenge in medical practice, particularly in oncology, as it directly impacts patient care and follow-up. Despite existing protocols to aid this process, both patients and healthcare professionals frequently highlight insufficient training in BBN. This study evaluates [1] the curricula and methodologies of teaching BBN at the study institution and [2] medical students' perceptions of the effectiveness and adequacy of their BBN education and training. METHODS: This cross-sectional, quantitative, exploratory study used a self-administered questionnaire with 25 questions developed by the researchers. Categorical variables were compared via the chi-square test or Fisher's exact test, with a significance level of 5%. RESULTS: A total of 300 questionnaires were completed by medical students from the 8th to 12th periods, comprising 205 women and 95 men, with an average age of 23.9 ± 3.4 years. Among the participants, 220 (73.3%) reported receiving some formal instruction on breaking bad news, but only 17.3% felt prepared for this task. A vast majority (95.7%) recognized the importance of being prepared to communicate bad news. At the beginning of their practical cycle, 74.6% of the students found "discussing the end of therapeutic options and palliative care" the most challenging. For those already in the practical cycle, 54.8% identified "communicating about the worsening of the disease" as the most difficult. CONCLUSION: Developing skills for breaking bad news is essential for a strong doctor-patient relationship. Teaching these skills in medical education is necessary to increase patient motivation and confidence in treatment.