8th December 2021

Breaking bad news to a patient might be an MMI station you’re dreading in the run up to your Med School Interview. It can be difficult to know how you would do this in real life, let alone in a short station of fewer than ten minutes. The actor at this type of station is employed to be realistic but also to test you, so they could overreact to anything you say that gives them a chance.

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 you should approach a breaking bad news MMI station.

Written by Safiya Zaloum

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Be Sensitive

Breaking bad news could range from telling an angry patient in A&E that they will need to wait a long time until they are seen, to giving a patient a difficult and life-changing diagnosis, or even having to tell a family member that their loved one has passed away.

Put yourself in the other person’s position and imagine how you would want a healthcare professional to communicate the news to you. Try to behave as sensitively and kindly as if you were talking to a friend, and this will make the patient/family member feel more at ease in your presence.

Speak Calmly and Clearly

Pretend this is a real situation and there is a real patient in front of you who is worried and possibly tired. 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 not speaking too quickly and by being as calm as possible. If you are 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.

Give Them Time To Process It

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 info.

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Silence Is OK

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 patient/family member processes the bad news is to stay quiet and watch them attentively.

Don’t stay silent for too long, but don’t be afraid to leave periods of silence if the other person is clearly processing the news.

Listen To Them

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. They may not speak for a while, at which point you may want to ask them if they have any questions for you, or give them a bit more information to process.

Offer Support

In real life, breaking bad news in six minutes (or however long your station is), and ensuring the patient/family member is fine, would be a big ask. Ideally, you would spend time talking to them about their options and how they want to proceed. However, in an MMI you don’t always have time to do this in the way you might hope.

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 having just broken the bad news with no potential follow-up or ongoing support offered to the person.

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