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During your Medical School interview, you might face an MMI station where you’re asked to break bad news – either to a patient or to someone else like a friend or neighbour. The actor at this type of roleplay station is employed to be realistic but also to test you, so they might get angry or upset and you will need to react appropriately.
To succeed, it’s essential to have good communication skills and to treat the situation sensitively. Here’s some advice for your interview prep on how to approach a breaking bad news station.
Breaking bad news in your MMI could range from telling a frustrated patient in A&E that they will need to wait a long time until they are seen, to informing a family member that their loved one has passed away. You could also face a non-medical scenario where, for example, you have to tell your neighbour that you broke a valuable, or emotionally significant, item in their home while housesitting for them.
Put yourself in the other person’s position and imagine how you would want someone to break bad news to you. Don’t be blunt, but don’t be too vague either. Try to behave as sensitively and kindly as if you were talking to a friend or family member, and this will make the other person feel more at ease in your presence.
Do your best to pretend that it is a real situation and that the person in front of you is really feeling the emotions they are expressing, not just acting. You need to communicate bad news to them and you don’t want them to misinterpret what you are saying, so speak clearly to avoid causing confusion or having to repeat yourself.
You want the other person to be as calm as possible when receiving the news, and you can help with this by keeping calm yourself and not speaking too quickly. If you seem nervous or worked up, they might pick up on this and mirror it – so try to be confident in yourself and what you are saying.
In real life, people need a little time to process and accept what they have heard, especially if it is life-changing news. Try not to overload the person with lots of non-essential information.
Explain the bad news clearly and concisely, then let them process it before you continue. Once they seem to have processed the initial news, move on to more details if appropriate. Try to stay in tune with their body language and facial expressions throughout, so you’ll have an idea of when they have processed the news and you can move on to further information.
It can be tempting, especially in an MMI station where time is limited, to talk a lot and try to fit in as much as possible. However, the most sensible thing to do whilst the other person processes the bad news is to stay quiet and watch them attentively.
Don’t stay silent for too long and waste time, but don’t be afraid to leave periods of silence if the other person is clearly processing the news.
Everyone reacts differently to bad news and there is no way to predict how the actor will react in your MMI station. If they start speaking or processing what you have told them out loud, make sure you listen to them.
Don’t try to interrupt them or respond to every single thing they say. If they ask you a direct question, answer them but give them time to talk it through first. If they don’t speak for a while, you may want to ask them if they have any questions for you, or give them a bit more information to process.
In real life, breaking bad news in under 10 minutes, and ensuring the other person is fine, would be a big ask. Ideally, you would spend more time talking to them about the situation. However, you don’t have a limitless amount of time to break bad news in an MMI interview.
If you’re playing the role of a Doctor talking to a patient, make sure you offer support – not just from yourself but from other services. You could offer counselling, or for them to talk to another member of the team. Try not to leave the station with no potential follow-up or ongoing support offered to the person.
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