title: Truth telling in medical practice: students' opinions versus their observations of attending physicians' clinical practice.
abstract: OBJECTIVE
  Truth telling or transmitting bad news is a problem that all doctors must frequently face. The purpose of this cross-sectional study was to investigate if medical students' opinions of truth telling differed from their observations of attending physicians' actual clinical practice.
  
  
  METHODS
  The subjects were 275 medical clerks/interns at a medical center in northern Taiwan. Data were collected on medical students' opinions of truth telling, their observations of physicians' clinical practice, students' level of satisfaction with truth telling practiced by attending physicians, and cancer patients' distress level when they were told the truth.
  
  
  RESULTS
  Students' truth-telling awareness was significantly higher than the clinical truth-telling practice of attending physicians (p<0.001), and the means for these parameters had a moderate difference, especially in three aspects: method, emotional support, and providing additional information (p<0.001). Regardless of this difference, students were satisfied with the truth telling of attending physicians (mean ± SD=7.33 ± 1.74). However, our data also show that when cancer patients were informed of bad news, they all experienced medium to above average distress (5.93 ± 2.19).
  
  
  CONCLUSIONS
  To develop the ability to tell the truth well, one must receive regular training in communication skills, including experienced attending physicians. This study found a significant difference between medical students' opinions on truth telling and attending physicians' actual clinical practice. More research is needed to objectively assess physicians' truth telling in clinical practice and to study the factors affecting the method of truth telling used by attending physicians in clinical practice.
authors.affiliation: School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan. wtang@mail.cgu.edu.tw
authors.forename: Woung-Ru
authors.initials: WR
authors.lastname: Tang
authors.forename: Ji-Tseng
authors.initials: JT
authors.lastname: Fang
authors.forename: Chun-Kai
authors.initials: CK
authors.lastname: Fang
authors.forename: Maiko
authors.initials: M
authors.lastname: Fujimori
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003142:Communication; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010820:Physicians / Q000523:psychology*; D010818:Practice Patterns, Physicians'; D013337:Students, Medical / Q000523:psychology*; D011795:Surveys and Questionnaires; D013624:Taiwan; D014342:Truth Disclosure