Family centered communication involves establishing a positive relationship with family members, mutual information exchange between family and staff, responding to family emotions, managing uncertainty and making shared decisions.  One particularly daunting  type of communication faced by physicians is delivering bad news. For many, their first experience involves patients they have known only a few hours. Additionally, they are called upon to deliver the news with little planning or training, which often leads to misunderstandings and conflict. Poor communication increases the risk of adverse psychological outcomes such as anxiety, acute stress disorder, posttraumatic stress for families. 

Historically, medical education has placed more value on technical proficiency than communication skills. This leaves physicians unprepared for the communication complexity and emotional intensity of breaking bad news. The fears doctors have about delivering bad news include being blamed, evoking a reaction, expressing emotion, not knowing all the answers, fear of the unknown and untaught, and personal fear of illness and death. This can lead physicians to become emotionally disengaged from their patients. Additionally, bad news delivered inadequately or insensitively can impair patients' and relatives' long-term adjustments to the consequences of that news.

In this course we will explore some strategies to communicate with patients and address the issue of how to “break bad news” in intensive care.