Although delivering bad news is something that occurs daily in most medical practices, the majority of clinicians have not received formal training in this essential and important communication task. A variety of models are currently being used in medical education to teach skills for delivering bad news. The goals of this article are (1) to describe these available models, including their advantages and disadvantages and evaluations of their effectiveness; and (2) to serve as a guide to medical educators who are initiating or refining curriculum for medical students and residents. Based on a review of the literature and the authors’ own experiences, they conclude that curricular efforts to teach these skills should include multiple sessions and opportunities for demonstration, reflection, discussion, practice, and feedback.
Dr. Rosenbaum is assistant professor of family medicine and Dr. Lobas is professor of pediatrics, Roy J. and Lucille A. Carver College of Medicine; Dr. Ferguson is associate professor of community and behavioral health, College of Public Health. All are at the University of Iowa, Iowa City.
Correspondence should be addressed to Dr. Rosenbaum, 1204 MEB, University of Iowa College of Medicine, Iowa City, IA 52245; e-mail: 〈firstname.lastname@example.org〉.