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From classroom to clinic: Addressing gaps in teaching and perceived preparedness for breaking bad news in medical education
Open accessAbstract
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.
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“a recent survey found that while over 70% of senior medical students had received some instruction in “breaking bad news,” only about 17% felt adequately prepared to actually deliver serious diagnoses to patients (Santos et al., 2025).”
From DIALOGUE: A Generative AI-Based Pre–Post Simulation Study to Enhance Diagnostic Communication in Medical Students Through Virtual Type 2 Diabetes Scenarios (2025) · cites this paper as Santos et al., 2025
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Cited by
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Suárez-García, R. X., Chavez-Castañeda, Q., Orrico-Pérez, R., Valencia-Marin, S., Castañeda-Ramírez, A. E., Quiñones-Lara, E., Ramos-Cortés, C. A., Gaytán-Gómez, A. M., Cortés-Rodríguez, J., Jarquín-Ramírez, J., et al. (2025) · European Journal of Investigation in Health, Psychology and Education · doi:10.3390/ejihpe15080152 · Cited by 18
“For example, a recent survey found that while over 70% of senior medical students had received some instruction in “breaking bad news,” only about 17% felt adequately prepared to actually deliver serious diagnoses to patients (Santos et al., 2025).”
Metadata
- Authors
- Santos, M. S., Cunha, L. M., Ferreira, A. J., & Drummond-Lage, A. P.
- Affiliations
- Faculdade de Ciências Médicas de Minas Gerais (BR)
- Venue
- BMC Medical Education
- Published
- 2025-03-27
- Volume
- 25
- Issue
- 1
- Pages
- 449-449
- ISSN
- 1472-6920 (ISSN-L)
- PMC
- PMC11951527
- OpenAlex
- W4408891125
- Cited by
- 13
- References
- 0
- Citations by year
- 2026: 9 · 2025: 4
- FWCI
- 16.40
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Medical Education (publishedVersion, cc-by-nc-nd)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Social Sciences › Education › Innovations in Medical Education
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Keywords
- breaking bad news, communication skills training, medical students, perceived preparedness, curriculum evaluation, oncology communication, physician-patient relationship, palliative care communication, medical education
- MeSH terms
- Adult, Communication, Cross-Sectional Studies, Curriculum, Education, Medical, Education, Medical, Undergraduate, Female, Humans, Male, Physician-Patient Relations, Surveys and Questionnaires, Students, Medical, Teaching, Truth Disclosure, Young Adult
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- Santos, M. S., Cunha, L. M., Ferreira, A. J., & Drummond-Lage, A. P. (2025). From classroom to clinic: Addressing gaps in teaching and perceived preparedness for breaking bad news in medical education. BMC Medical Education. https://doi.org/10.1186/s12909-024-06498-5
