Should ophthalmologists receive communication skills training in breaking bad news?

Background: Effective communication is essential in the delivery of health care. The purpose of the present study was to determine whether formal communication skills training in breaking bad news should be incorporated into the training of ophthalmologists.

Methods: An online survey was offered to every member of the Canadian Ophthalmological Society (COS) with a registered email address. Survey questions focused on 2 specific scenarios: (S1) disclosing permanent vision loss to a patient and (S2) revoking a patient's driver's licence. Main outcome measures were the respondents' opinions on the need for and benefit of including communication skills in the training of ophthalmologists and, if considered necessary, its optimal format and point in their training.

Results: The response rate was 28% (225/800). The vast majority of respondents believed that it is important for ophthalmologists to be able to communicate effectively when breaking bad news (S1: 99%, mean Likert score 4.81; S2: 97%, 4.73); that communication skills training would be beneficial in breaking bad news for both future ophthalmologists (S1: 88%, 4.28; S2: 87%, 4.24) and patients (S1: 92%, 4.26; S2: 87%, 4.24); and that it should be included in the training of ophthalmologists (S1: 87%, 4.27; S2: 83%, 4.15). Residency was the preferred point in training (95% for both scenarios), but there was no consensus on what type of training format(s) to use.

Interpretation: Survey respondents strongly support the inclusion during ophthalmology residency of formal communication skills training in breaking bad news. This would be a logical choice of content for ophthalmology residency programs striving to meet the mandated "interpersonal and communication skills" core competency requirements.