Giving bad news has been identified by physicians as a difficult task. This study compares the skills of first-year medical students to those of third-year students that had received training in giving bad news using role-play with standardized patients. Observers completed a checklist developed to determine student skill level.
Third-year students did better on several checklist items, including giving a “warning shot” (X2=21.4, p=.0001) and giving information in small chunks (X2=13.02, p=.0001). First-year students performed better in basic skills such as assessing social support (X2=51.46, p=.0001) and summarizing the discussion (X2=37.59, p=.0001).
It is likely that specific training in delivering bad news is a key factor in explaining the superior performance of third-year students in areas particularly relevant to giving bad news. However, first-year students were more proficient in some basic interviewing skills. The authors recommend that basic interviewing skills be reinforced throughout the medical school curriculum.