A Narrative Review of Interventions to Teach Medical Students How to Break Bad News.

Abstract

Breaking bad news (BBN) is a key advanced communication skill that physicians must learn. Despite the breadth of literature describing patients' preferences and data citing poor physician competency in this arena, there remains significant dissatisfaction with how doctors deliver bad news. One way to solve this dilemma is to ensure that we are using the best evidence-based educational approaches to train the cadre of medical students who graduate from medical school each year. This article provides a 15-year review of articles on BBN in the undergraduate medical education curriculum that have been validated using the Medical Education Research Quality Instrument (MERSQI) (Acad Med 90:1067-76, 2015). This narrative review aims to identify articles which describe undergraduate medical education curriculum that evaluate how to best teach students to communicate bad news to patients. In the process, the authors reviewed 179 abstracts in 118 academic journals. Articles that met the inclusion criteria were evaluated using the MERSQI and those that scored higher than 11.3 were chosen for analysis. This paper summarizes the 15 articles that met the criteria. The review reveals (1) standard components which should be included in an undergraduate BBN curriculum, (2) a pressing need for utilizing a teaching and evaluation tool that incorporates nonverbal communication, and (3) a further need to test long-term curriculum retention.