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Breaking Bad News using Role-Playing: A Multimedia Instructional Activity for Faculty/Facilitators Teaching Medical Trainees

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A small-group instructional session on breaking bad news has been a component of the medical student curriculum in the University of Miami Miller School of Medicine’s Longitudinal Theme in Geriatrics, Pain Management and Palliative Care for many years. The session used two complex clinical scenarios; each unfolding over 3-parts (see van Zuilen, et. al., at For several years, faculty/facilitators expressed anxiety and uncertainty in their abilities to facilitate these complex scenarios using role-playing. In order to address faculty concerns the lead author developed a variety of shorter cases that progress through increasingly more difficult clinical scenarios. The author used these shorter clinical scenarios over several years and the sessions were rated equally well by students compared to the original cases. The faculty curriculum developers believed this new format lent itself to recording as a multimedia module: shorter cases more readily demonstrate the skills of delivering bad news. This recorded instructional activity was prepared and produced through a collaborative effort between faculty and students. We believe this recorded adaptation of the breaking bad news session provides a valuable learning opportunity and resource for faculty, especially those with limited experience in facilitating role-playing instructional activities. One drawback in using shorter cases is that students have a limited opportunity to practice the structured format (Buckman’s 6-step or SPIKES) for delivering bad news. Students may need to be given other opportunities in the curriculum to demonstrate their competency in using a structure format.

Educational objectives: 

Learning objectives for Faculty/Facilitators

After viewing and understanding the module and related materials, faculty/facilitators will be able to:

  1. use role-playing as an instructional activity
  2. implement or augment a role-playing instructional activity for breaking bad news within their curriculum


Learning objectives for Students

Using short scenarios, the student will:

  1. Appreciate the physician’s responsibilities regarding breaking bad news
  2. Understand the six-step protocol for breaking bad news
  3. Appreciate the impact receiving bad news can have on patients
  4. Develop communication skills for breaking bad news
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To view the original educational material from which this material was adapted, see van Zuilen, et. al., at

Date posted: 
Fri, 01/24/2014
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Fri, 01/24/2014
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Suggested Citation:
Breaking Bad News using Role-Playing: A Multimedia Instructional Activity for Faculty/Facilitators Teaching Medical Trainees. POGOe - Portal of Geriatrics Online Education; 2014 Available from:
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