Assessing “Breaking Bad News” Communication Competency in Midwifery Students

Kathi Wilson, BA, BHSc, MSc (c)

ABSTRACT
The communication task of conveying difficult news to patients by health care providers, described in the literature as “breaking bad news,” is one that is often performed poorly. There is, at the same time, a relatively small amount of research in the health sciences education literature devoted to the assessment of this particular competency. Like other health care providers, registered midwives in Canada are expected to have knowledge and skill in this domain of communication. In the Ontario Midwifery Education Program, senior students are expected to develop competence in managing situations involving loss during the childbearing year; however, there is little guidance for preceptors with respect to the assessment of performance for this skill. This article reviews the relevant literature on the assessment of “breaking bad news” and workplace assessment tools in health education, and proposes the use of a clinical encounter card that uses a modified Breaking Bad News Assessment Scale to assist and guide preceptors. Further investigation of the tool’s reliability, validity, and acceptability to preceptors is needed.

KEYWORDS
breaking bad news, midwifery education, performance assessment, workplace-based assessment

This article has been peer reviewed.