[Breaking bad news--a video-based training unit for medical students]

In 2002, the Medical Licensing Board prescribed fundamental changes in medical education. The reformed curriculum set its focus on bed-side teaching in small groups, problem-based courses, and training of communication skills. The previous curriculum did not include the teaching of communication skills to future physicians. Physicians thus felt unprepared for the doctor-patient communication.

Within the newly derived Medical Curriculum Munich (MeCuMLMU), the School of Medicine at the Ludwig-Maximilian-University of Munich implemented in 2005 a teaching unit named "Breaking Bad News" in order to train the students' communication skills. Its main elements are videotaped role-plays and the subsequent video-based analyses. In the role-plays, students experience the parts of a physician and a couple of parents. The task of the physician is to break the news of a severe condition to the parents of a child. The teaching units are held by members of the department of child psychiatry together with fifteen members of the department of paediatrics who had been instructed in analyzing videotaped role-plays. A manual was developed to facilitate a standardized approach.

The teaching units were evaluated by means of questionnaires filled in by students and tutors. The evaluation showed that "Breaking Bad News" was highly appreciated by both students and tutors. Our experience showed that this type of instruction is suitable to improve the communication skills of medical students, and it is feasible despite the relatively extensive technical and personnel resources needed.