["Truth at the bedside"--continuing medical education and breaking bad news].
BACKGROUND
Discussions with seriously-ill patients are part of the physicians' tasks. These discussions demand good communication skills. In this paper we present the concept of a postgraduate course for physicians on ethics and breaking bad news, as well as the results of the course evaluation.


METHODS
Questionnaire distributed before and immediately after the course using closed-ended questions and Likert scales.


RESULTS
37 physicians (response rate: 84.1%) from seven specialties completed the questionnaires. Twenty-eight respondents (75.6%) had been involved in breaking bad news more than 5 times per month. Approximately half of the respondents (N = 18; 48.6%) rated the discussions on the limits of curative treatment as particularly difficult communication situations. With one exception, all physicians denied the existence of guidelines on breaking bad news in their institutions. Compared with the beginning of the course, the respondents rated their communication skills to be improved at the end of the course. Positive evaluations were obtained for practice relevance, teaching methods, and organisation of the course.


CONCLUSIONS
The interest in this optional postgraduate course and the feedback of the participants indicate the necessity of professional training on difficult communication situations. The self-rating of improved communication skills may be interpreted as a positive effect of the course. Observational studies are required to confirm the effects of the training.
Schildmann
Jan
J
Medizinische Klinik III und Institut für Geschichte und Ethik der Medizin, Friedrich-Alexander-Universität Erlangen-Nürnberg. jan.schildmann@ethik.med.uni-erlangen.de
Herrmann
Eva
E
Klambeck
Amelie
A
Ortwein
Heiderose
H
Schwarz
Carsten
C
Vollmann
Jochen
J
D004502:Education, Medical, Continuing / Q000592:standards*; D006801:Humans; D007258:Informed Consent; D008511:Medicine; D013038:Specialization; D011795:Surveys and Questionnaires; D014342:Truth Disclosure / Q000941:ethics*