Breaking Bad News

Prompt: Watch 2–3 publicly available training or role‑play videos where clinicians deliver difficult news. Analyse the interaction, focusing on both examples of good and bad practices.

Task overview

Breaking bad news is a core skill in clinical communication. This task involves watching 2–3 short videos made for training purposes where clinicians practise delivering difficult news and discuss points to note. Your goal is to analyse how the clinician structures the conversation, manages the patient’s emotional response, and demonstrates empathy.

You will also compare good practices with bad practices.

To get you started

1. Choose 2–3 videos from the list

Below are some links you could use. They show role plays or simulations in which a clinician delivers difficult news, as well as discussions about this encounter.

2. Observe how clinicians prepare and open the conversation

Make notes on:

How they introduce themselves
How they prepare the patients for the bad news, this could include:
Whether and how they check the patient’s awareness of the situation
Whether and how they set expectations (“I’m afraid we need to talk about your test results…”)

3. Analyse the delivery of the news

Look for:

Any cues to signal difficult news is coming (also called ‘warning shots’)
Clarity vs. vagueness
Use of simple vs. overly technical language
Any display of empathy and compassion (e.g., intonation and other non-verbal cues)
Interaction practices that allow emotional reactions (e.g., pauses, and pacing)
Ability to respond to emotions

4. Identify good practices

Examples:

Checking understanding (“Can I pause to check what you’ve taken from this so far?”)
Display of empathy and compassion through verbal means (“I can see this is a shock…”)
Display of empathy and compassion through non-verbal means (e.g., allowing silence)
Means to give space to patients to react and to validate their feelings
Offering follow‑up or next steps

5. Identify problematic practices

These may include but do not limit to:

Rushing the conversation due to time pressure
Using technical jargon without explanation
Giving too much information at once
Appearing detached or unempathetic

6. Compare the examples

Write a short comparison to discuss:

What practices best meet the needs (both communicative and emotional) for the encounter, and why
Which mistakes are most noticeable in the weaker example(s), and how they impact both the informational and the interpersonal aspects of the encounter

7. Write your conclusion

Summarise:

What makes breaking bad news sensitive and supportive
Key strategies professional training could prioritise (e.g., giving warning shots, displaying empathy, summarising)