Improving the skills of doctors in giving distressing information.

In response to the growing awareness of the need to convey distressing information effectively, four workshops were held for doctors across Britain with the aim of improving skills, knowledge and attitudes. From the unexpectedly large response of 441 nominations, 20 participants were selected for each workshop. Participants identified four major concerns: how to do it; where to give distressing information; how to deal with collusion; and how to survive mentally in the work. After sessions on these areas, participants interviewed a simulated patient and were recorded on videotape for subsequent feedback. The results showed that after brief training, 91% of all participants gave a warning of distressing information, 85% gave the information at the patient's pace, but only 5% attempted to 'pick up the pieces'. Further work is required on this key aspect of clinical work.