Introduction: Delivering bad news to patients is a challenging and daily task for physicians, rooted in the principle of respect for patient autonomy. This study aimed to evaluate the skills of medical specialists, residents, and interns in breaking bad news and to identify factors influencing these skills based on the SPIKES protocol.
Methods: This cross-sectional study was conducted in 2023 at selected teaching hospitals in Isfahan. A total of 321 healthcare professionals, including 57 specialists, 102 residents, and 162 interns, were selected using quota sampling. Data were collected using the standard SPIKES questionnaire, which assessed participants' skills in two domains: environmental and psychological factors. Data were analyzed using independent t-tests and one-way ANOVA in SPSS version 24 software.
Findings: Findings indicated that specialists achieved significantly higher scores in the psychological domain compared to residents (P=0.037). Prior knowledge of specific Breaking Bad News (BBN) guidelines was the most influential variable in improving participants' performance across all domains and total skill scores (P<0.05). Furthermore, interns who had personal experience of receiving bad news in their own lives achieved higher scores in news delivery skills (P=0.016). Variables such as gender, marital status, and work experience had no significant impact on the mean self-assessment scores of skills.
Conclusion: A large proportion of participants were unfamiliar with specific guidelines for breaking bad news, highlighting the necessity of revising medical education programs