Educational interventions to improve medical students' bad news communication skills: A systematic review and meta-analysis.

Alanna McMullin; Colm O'Tuathaigh; Erik Montagna

doi:10.1016/j.pec.2026.109818

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Educational interventions to improve medical students' bad news communication skills: A systematic review and meta-analysis.

Alanna McMullin·Colm O'Tuathaigh·Erik Montagna

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Abstract

OBJECTIVES: This systematic review aimed to both determine whether educational interventions improve medical students' ability and/or confidence in Bad News Communication (BNC), as well as assess the relative efficacy of instructional formats. METHODS: Performed according to the PRISMA guidelines, four databases were searched for articles describing education-based interventions to improve medical student's BNC ability and/or confidence, published in English between 2001 and 2024. Data on students' self-reported or observer-assessed level of competence/ability in BNC (primary outcome), and students' self-assessed confidence in BNC skills (secondary outcomes), were analysed. Meta regression explained the influence of several categorical moderators on heterogeneity in relation to intervention effects on competence/ability. RESULTS: 27 studies met the criteria for inclusion in the systematic review and 17 studies for the meta-analysis. Interventions described in controlled studies were associated with a moderate and significant increase in BNC ability (13 data sets; standardized mean difference [SMD] = 1.09, 95% CI = 0.52 - 1.66). Interventions detailed in pre-post design studies were associated with a significant increase in BNC ability (20 data sets; SMD = 0.92, 95% CI = 0.52 - 1.32), and student confidence/comfort in their BNC skills (12 data sets; SMD = 1.16, 95% CI = 0.57 - 1.75). Subgroup analysis demonstrated better skills/competence outcomes in studies that included simulation-based training (SBT). CONCLUSIONS: Educational interventions improve the BNC ability and confidence of medical students. Interventions should include an SBT element as this leads to greater improvements in BNC ability. Further research is needed to determine to what extent these interventions translate to positive patient outcomes. PRACTICE IMPLICATIONS: Diverse educational programme, especially those including simulation-based training, are effective in improving BNC skills, although the longetivity of these improvements is at present unclear. Therefore, we recommend that refresher courses or practice opportunities should be scheduled throughout students' medical education to ensure retention of BNC skills.

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Humans Communication Students, Medical Clinical Competence Truth Disclosure Physician-Patient Relations Education, Medical, Undergraduate Bad news communication Educational intervention Medical students Meta-analysis Systematic review Journal Article Systematic Review Meta-Analysis Review

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Alanna McMullin, Colm O'Tuathaigh, Erik Montagna. 2026-08-11. Educational interventions to improve medical students' bad news communication skills: A systematic review and meta-analysis.. https://doi.org/10.1016/j.pec.2026.109818

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Clinical Competence subject Humans subject Journal Article subject Journal Article; Systematic Review; Meta-Analysis; Review resource Meta-Analysis subject Systematic reviews study

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