title: Delivering bad news to a patient: a survey of residents and fellows on attitude and awareness.
abstract: OBJECTIVE
  Delivering bad news (DBN) to a patient or patient's family is one of the most difficult tasks for physicians. As a complicated task, DBN requires better than average communication skills. This study investigated trainee's attitude and awareness of DBN based on a self-assessment of their experiences and performance in practice. Survey subjects were also asked to assess their perception and the need for education in conducting DBN.
  
  
  METHODS
  A survey was carried out on their experiences with DBN, how they currently deal such situations, how they perceive such situations and the need for education and training programs. A SPIKES protocol was used to assess how they currently deal with DBN.
  
  
  RESULTS
  One hundred one residents and fellows being trained in a teaching hospital participated in the survey. Around 30% had bad experiences due to improperly delivered bad news to a patient. In terms of self-assessment of how to do DBN, over 80% of trainees assessed that they were doing DBN properly to patients, using a SPIKE protocol. As for how they perceived DBN, 90% of trainees felt more than the average level of stress when they do DBN. About 80% of trainees believed that education and training is much needed during their residency program for adequate skill development regarding DBN.
  
  
  CONCLUSIONS
  We suggest that education and training on DBN may be needed for trainees during the residency program, so that they could avoid unnecessary conflict with patients and reduce stress from DBN.
authors: Division of Hematology/ Oncology, Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea.
authors: Hye Ran
authors: HR
authors: Lee
authors: Division of Hematology/ Oncology, Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea.
authors: Seong Yoon
authors: SY
authors: Yi
keywords: Bad news; Communication; Disclosure; Education