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Difficult Conversation Case: Missed Testicular Cancer
Joshua Ginsburg1, Sarah Zamamiri1, Marshall Howell1
1University of Texas Southwestern Medical Center, Department of Emergency Medicine, Dallas, TX.
Journal of Education & Teaching in Emergency Medicine
|January 12, 2026
Summary
This emergency medicine case effectively prepared residents for breaking bad news, with 100% finding it improved understanding of the certifying exam and rated its quality highly.
Area of Science:
- Medical Education
- Emergency Medicine
- Communication Skills
Background:
- Effective communication is crucial in emergency medicine for patient outcomes.
- Residency training must emphasize communication skills, tested on the American Board of Emergency Medicine (ABEM) Certifying Exam.
Purpose of the Study:
- To assess emergency medicine residents' ability to disclose a missed testicular cancer diagnosis.
- To evaluate residents' skills in rapport building, empathy, and patient-centered care planning.
Main Methods:
- A 10-minute Objective Structured Clinical Exam (OSCE) case was developed to simulate breaking bad news.
- Residents were evaluated using a 15-point rubric based on ABEM objectives, focusing on communication frameworks like SPIKES and NURSE.
Main Results:
- All 17 participating residents (100%) agreed the case improved their understanding of the certifying exam format.
- Residents achieved a mean score of 13.35/15, with 100% rating the case quality as very good or excellent.
Conclusions:
- The case effectively enhanced residents' understanding of certifying exam communication scenarios.
- Residents performed well but may benefit from further training in disclosing sensitive information using structured communication frameworks.
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