The impact of breaking bad news on oncologist burnout and how communication skills can help: A scoping review

Oncology is regarded as one of the more stressful specialties in medicine. Repeated exposure to working with patients and families and dealing with a disease with a high mortality rate results in oncologists frequently encountering a myriad of highly stressful situations, from breaking bad news to addressing topics such as death, dying, and palliative care. Breaking bad news is a particularly complex communication task, and feeling uncomfortable disclosing negative information may lead to even higher burnout rates among oncologists. Improving communication skills has been identified as an effective means to reduce burnout. Objective: This paper aims to review the impact that breaking bad news may have on oncologists, and how enhancing communication skills may help reduce burnout. Methods: A literature search of Cochrane CENTRAL, Ovid Embase, and Ovid MEDLINE was conducted to identify relevant studies. Studies were included if the primary subjects were oncologists and both the impact of breaking bad news on oncologist burnout and the effect of communication skills on burnout were reported. Results: Four studies met eligibility criteria and were included. Findings suggested oncologists experienced burnout from breaking bad news to their patients, as measured on the Maslach Burnout Inventory. The overall assessment of communication skills training showed varied yet positive responses. Conclusions: Burnout is frequently characterized by feelings of emotional exhaustion, depersonalization, and low personal accomplishment. In oncology, the practice of breaking bad news to patients has been identified as a source of burnout. Enhancing communications skills to assist in improving the way negative information is disclosed can provide oncologists with skills to mitigate stress and ultimately reduce burnout.