The Challenges and Solutions of Breaking Bad News in Midwifery: a Narrative Review

Introduction: Due to the high prevalence of adverse events during pregnancy and childbirth, the present study was conducted as a narrative review study investigating the challenges of disclosing bad news in the midwifery field and various intervention approaches for teaching bad news. Method: This study is in the form of a narrative review and by searching Persian and English databases including Medline, PubMed, Embase, Web of Science, Scopus, CINAHL, IRANDOC, Google Scholar, Iranmedex, medlib, Sid, and Mag-Iran with key Words including bad news, midwifery, childbirth, pregnancy, spikes (S-P-I-K-E-S), midwifery education were conducted in the time range of 1990-2022. Finally, 20 quantitative and qualitative articles were included in the research. Results: These articles were examined in two areas: the challenges of health personnel in conveying bad news and different strategies for teaching how to convey bad news. In studies, various techniques have been used to teach the delivery of bad news, such as Spikes protocol, ABCDE method, simulated patient or Mini-CEX, in the teaching of delivery of bad news in various fields of obstetrics, such as IVF failure, intrauterine death, etc. have been. The use of clinical encounter cards or CECs, Asci tests and Mini-CEX are techniques that were used to evaluate students. Conclusion: Proper transmission of bad news is one of the challenges of healthcare personnel. Using appropriate educational techniques for students and medical personnel can reduce the negative consequences of inappropriate transmission of bad news.