A Novel Approach on Breaking Bad News

Educating students on how to deliver news of death can be a challenge for nurse practitioner faculty. Often the content is taught in a lecture format which may not clearly emphasize the nurse practitioner’s own emotion in the resuscitation, limited time to prepare, and understanding of the wide array of emotions family members may display in times of stress. We wanted to approach end of life education for acute care nurse practitioner students in a real time, simulated approach with reflection and group debriefing as a method to increase the robustness of the content.

In an effort to ascertain a novel approach to teaching breaking bad news we utilized our residency week format to deliver the content. Individually the ACNP student entered a brief and tragic code scenario followed by directly proceeding to the ‘family room’ where a standardized patient portrayed the role of family member as the student delivered the bad news in real time.

Once students completed the delivery of bad news they went to a private space and journaled anonymously about the experience. Those journal entries were reviewed for themes. The themes were the core of a three hour workshop and roundtable discussion on end-of-life management in the hospital patient, family decision making, and delivering bad news which occurred after the simulation experience. A robust discussion, led by faculty, with extensive student participation allowed participants to reflect on their own biases and ethics while further learning the six steps of delivering bad news.  Student responses are being analyzed for research opportunities, teaching strategies and further interdisciplinary education sessions at the university.