This e-learning guide teaches trainees how to effectively break bad news to patients. It discusses that breaking bad news is a complex communication skill that requires additional training. The guide outlines strategies for preparing, sharing information, and showing empathy when delivering bad news, and stresses the importance of planning follow-up support. Trainees are instructed to practice applying these strategies through formative tasks.

1. An essential skill to acquire

2. Who is it aimed
"Breaking Bad News“ It is a mandatory e learning guide
for foundation trainees. It is an e learning resource for
the trainees to help them prepare to deliver bad news
to patients and their families.

3. Objectives
By the end of the tutorial,students should understand—
 What is bad news.
 Why breaking bad news is a skill.
 why do we need additional training.
 To learn the strategy .

4. What is bad news
Bad news can mean different things to different people.
Can be defined as any information that
 adversely affects an individuals view of future
 carries a feeling of no hope or a threat to a person's
mental or physical well-being
 risks upsetting an established lifestyle
 conveys to an individual fewer choices in his or her
life. ref

5. Examples include
 A patient is diagnosed HIV positive.
 The patient who has been diagnosed with cancer.
 The couple who are told they cannot have children.
 The common denominator is that bad news is a
message, which has the potential to shatter hopes
leading to very different lifestyles.

6. Formative task
 Reflect on the challenges that you might face while
breaking bad news.
 Upload this task on blackboard

7. Formative task
 Reflect on the strategies you need to have prior to
breaking bad news.
Upload this task on blackboard

8. Why is it a skill?
 Breaking bad news is never a pleasant task.
 Doing it in wrong way or at the wrong time can be
even worse.
 It is just as hard for the person breaking the bad news
as it is for the person receiving it.

9. Why additional training
 It is a complex communication task.
 Involves using verbal and non verbal skills.
 If bad news is delivered poorly, can have a long lasting
impact in addition to the shock of bad news.
 When staff are uncomfortable to deliver bad news, can
lead to conveying unwarranted optimism.

10. Strategies
Preparing for the interview
 Go through the records and know the clinical situation
 Work through your own reaction to the news
 Give thought to how you would approach the delivery of bad news
 Think and practice what you are going to say.
 Assess your role and the level of information that you can give.
 Have the necessary information you need regarding the diagnosis and
treatment and support the patient needs thereafter.

11. Strategies- Contd-
 Choose an appropriate place.
 Choose the right time
 allow enough time for the interview
 Invite spouse, friend or relative as appropriate

12. Interview
 Communication
 Start off with a sentence which will suggest the news is
going to be a bad one.
 Get to the point and do need beat round the bush.
 Use simple words, avoid jargon, be as clear as possible
 Be honest
 Give information in small chunks
 Watch the pace

13.  Show Empathy
 Read the body language for non verbal clues- tears,
silences
 Encourage expression of feelings
 Allow time for questions
 Check understanding of information given

14. Dealing with situation afterwards
 Planning and support
 Identify further plan
 Give broad time frame for what may lay ahead
 Emphasize quality of life
 Identify support system

15. Summary
 Preparing for the interview
 Sharing the information
 Showing empathy
 Planning and support

16. References
 Buckman R. (1992) Breaking Bad News: A Guide for Health Care Professionals.
Baltimore: Johns Hopkins University Press.
 Bor R, Miller R, Goldman E, Scher I. (1993) The Meaning of Bad News in HIV Disease:
counselling about dreaded issues revisited. Counsel Psychol Q. 6:69-80
 Maguire P (1985) Barriers of Psychological Care to the Dying.
 British Medical Journal 291:1711-1713
 Ptacek JT, Eberhardt TL. (1996) Breaking Bad News. A Review of Literature. JAMA 276:
496-502
 Baile W, Buckman R. et al. (2000) SPIKES- A Six Step Protocol for Delivering Bad News:
Application to the Patient with Cancer. The Oncologist 5:302-311