Barriers to breaking bad news among medical and surgical residents

Abstract

Although most residents realize important guidelines in the delivery of bad news, their own fears, a general lack of supervisory support and time constraints form barriers to their effective interaction with patients.

Balancing patient care and student education: Learning to deliver bad news in an optometry teaching clinic

“…The 'bad news' literature has examined patient and physician experiences with bad news delivery (e.g., Dias et al 2003;Flocke et al 2002;Lee et al 2002;Quill and Townsend 1991), strategies for delivering bad news (e.g., Arber and Gallagher 2003;Baile et al 2000;Barnett 2004;Cooke et al 2003;Dias et al 2003;Howard and Ehrlich 1998;Lee 1997;Lee et al 2002;Maynard 1996;Ptacek and Ellison 2000;Quill and Townsend 1991), and educational practices in the delivery of bad news (e.g., Cushing and Jones 1995;Dosanjh et al 2001;Farber et al 2002;Gillotti et al 2002;Rosenbaum et al 2004). In the past 10 years, medical protocols for delivering bad news have also emerged (e.g., Baile et al 2000;Kaye 1996; Lee et al 2002).…”

How stressful is doctor–patient communication? Physiological and psychological stress of medical students in simulated history taking and bad-news consultations

“…Stress can be related to workload, time pressures, technical complexities of tasks, medical errors (West et al 2006) and emotional burden of tasks, often evoked in interpersonal relations and communication (Cohen et al 2005, Ptacek andMcIntosh, 2009). In medical communication particularly emotionally burdensome tasks like breaking bad news or dealing with dying patients are frequent sources of distress (Espinosa et al 1996, Ptacek et al 1999, 2009, Dosanjh et al 2001, Redinbaugh et al 2003. Physicians perceive breaking bad news as a stressful task and there is little evidence that this gets easier as doctors become more experienced (Fallowfield and Jenkins, 2004, Helft and Petronio, 2007, Ptacek and McIntosh, 2009.…”

Teaching midwife students how to break bad news using the cinema: An Italian qualitative study

“…Discomfort with disclosing bad news may be due to many factors: lack of training, fear of patients' emotional reactions, fear of being blamed for the bad news, fear of one's own emotional reactions, fear of the patients' suffering and death, personal fear of illness and death, and uncertainty associated with not being able to provide answers (Buckman, 1984). Institutional barriers such as inadequate amounts of time or not having adequate support from other members of the hospital institution are also reported (Dosanjh et al, 2001). The reluctance to communicate bad news has been recognized for a long time.…”