Table 3 Breaking Bad News – What raises confidence?

▪ Lectures/training in breaking bad news (and/or in PC) (e.g., P2E)

▪ Practical clinical experiences/clinical exposure (also as a medical student), including but not limited to practical clinical exposure to PC in particular (e.g., S4I)

▪ Learning from (senior) colleagues (e.g., G2E)

▪ Having a format, a guideline, a standard to follow (e.g., G4I)

▪ Continuous reminders/raised awareness on the importance of breaking also bad news and on communicating appropriately with patients (e.g., G4I)

▪ (General) clinical knowledge (e.g., M1E)

▪ Being able to empathize with patients (e.g., P6I)

▪ The fear of losing the patients’ trust/of misinforming the patient if not communicating the assumed right way (e.g., S6I)

▪ Working in a team (e.g., M2E)

▪ Personal understanding of the professions’ ethics and duties (e.g., P3E)

▪ Being familiar with the society/the people’s mindset (e.g., P7E)

▪ Being emotionally detached from the patient (e.g., S2E)

▪ Communicating bad news to a PC patient – where the outcome is clear – versus a patient where a curative approach was taken (e.g., G4I)