Breaking Bad News During COVID-19 Time in Surgical, Emergency and Medical Specialties - What More we Need to Develop?

BACKGROUND: Breaking bad news is one of the complex communication skills essential to the practice of every clinician. It involves not only the mere provision of information, but also how to deal with the emotions of the patients and the response of their relatives. Therefore, certain protocols are employed for this process, including "BREAKS", "SPIKES", and “ABCDE” protocols. The emergence of the COVID-19 pandemic mandated the use of strict infection control measures including social distancing, requiring the utilization of telecommunication technologies for breaking bad news. OBJECTIVE: The aim of the study was to assess the use on non-physical methods in breaking bad news by physicians and to evaluate the need for more development and training. METHODS: Cross-sectional survey conducted in Kufa Medical College Al-Najaf during April - June 2021, and included 60 physicians of various specialties working in that hospital. RESULTS: Majority of participants 88.3% reported breaking bad news regularly. Less than half of participants 46.7% received training on breaking bad news, and only 13.3% received training on non-physical breaking bad news. More than half of participants mentioned that showing empathy is the area that needs improvement the most. CONCLUSION: High proportion of physicians lacks the necessary skills to break bad news, especially using non-physical ways during the pandemic. Well-structured programs are needed for the training of healthcare providers on breaking bad news, with certain adaptations for traditional protocols to be appropriate for telephone or video conferencing.