• N Horwitz and J Ellis.
• Greenland Road Children's Centre, London, UK. nicole_horwitz@hotmail.com
• Child Care Health Dev. 2007 Sep 1; 33 (5): 625-30.

AimsTo ascertain the level of support and training available to paediatric specialist registrars (SpRs) in breaking bad news and their self-reported confidence in this task.Study DesignA questionnaire-based survey.ParticipantsPaediatric SpRs working in North Thames region.MethodsSpecialist registrars (n = 206) were sent a questionnaire relating to the level of support and training available to them in breaking bad news and their attitudes to this task. A repeat questionnaire was sent out 2 weeks later.ResultsThe response rate was 54.9%. The study sample included 78 females and 34 males. The median year of qualification was 1995 [interquartile range (IQR) 1993-1997] and the median year of Calman training was Year 3 (IQR 2-4). Only 15.9% of participants had guidelines where they worked and 91.2% had received training in breaking bad news. Median self-perceived confidence in breaking bad news was rated as 4 out of 5. Only 21.2% of all respondents had both disclosed a diagnosis of Down syndrome and received feedback on their performance from their seniors. Few SpRs were able to adhere to all evidence-based recommendations for breaking bad news.DiscussionMost SpRs had received training in breaking bad news and self-reported confidence in this skill was high, although their hands-on experience was limited. Recent research shows, however, that parental dissatisfaction with the way in which bad news is broken remains high. The potential discrepancy between self-reported confidence and actual competence casts doubt on the value of self-evaluation.

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