{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T17:53:03Z","timestamp":1781632383729,"version":"3.54.5"},"reference-count":17,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T00:00:00Z","timestamp":1769212800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T00:00:00Z","timestamp":1771286400000},"content-version":"vor","delay-in-days":24,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Med Educ"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Breaking bad news (BBN) represents one of the most behaviorally and emotionally demanding communication skills in medical practice, particularly for residents who are still developing their professional and interpersonal competencies. Despite its ethical and psychological complexity, structured communication training remains insufficiently integrated into residency curricula in Romania.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross-sectional, single-center study explored the behavioral preparedness, attitudes, and perceived training needs of Romanian medical residents regarding BBN. A total of 193 residents from multiple specialties at Mure\u0219 County Clinical Hospital, T\u00e2rgu Mure\u0219, completed a self-administered questionnaire assessing their experiences, emotional reactions, perceived barriers, and familiarity with communication protocols such as SPIKES. Participation was voluntary, responses were anonymous, and completion of the questionnaire implied informed consent.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Most respondents (94.3%) acknowledged the importance of BBN, yet only 31.6% had practical experience, and 17.6% reported formal training. Awareness and use of structured communication frameworks were limited but correlated with greater confidence and empathy. Experience increased with residency year and varied across specialties.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Romanian medical residents recognize the ethical and emotional significance of breaking bad news but lack structured educational preparation. The findings underline the need for targeted behavioral and educational interventions to strengthen residents\u2019 preparedness, emotional resilience, and patient-centered communication competence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>Not applicable.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12909-026-08660-7","type":"journal-article","created":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T09:47:02Z","timestamp":1769248022000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Communication competence and behavioral challenges in breaking bad news: a single-center study of Romanian medical residents"],"prefix":"10.1186","volume":"26","author":[{"given":"Corina","family":"M\u0103rginean","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreea Cristina","family":"Safta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiberiu-Bogdan","family":"Szekely","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra-Daniela","family":"Szabo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sorin","family":"Albu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nimr\u00f3d","family":"L\u00e1szl\u00f3","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corina","family":"Budin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,1,24]]},"reference":[{"key":"8660_CR1","doi-asserted-by":"publisher","first-page":"1597","DOI":"10.1136\/bmj.288.6430.1597","volume":"288","author":"R Buckman","year":"1984","unstructured":"Buckman R. Breaking bad news: why is it still so difficult? BMJ. 1984;288:1597\u20139. https:\/\/doi.org\/10.1136\/bmj.288.6430.1597.","journal-title":"BMJ"},{"issue":"6","key":"8660_CR2","doi-asserted-by":"publisher","first-page":"496","DOI":"10.1001\/jama.1996.03540060066030","volume":"276","author":"JT Ptacek","year":"1996","unstructured":"Ptacek JT, Eberhardt TL. Breaking bad news. A review of the literature. JAMA. 1996;276(6):496\u2013502. https:\/\/doi.org\/10.1001\/jama.1996.03540060066030.","journal-title":"JAMA"},{"issue":"12","key":"8660_CR3","first-page":"1975","volume":"64","author":"GK VandeKieft","year":"2001","unstructured":"VandeKieft GK. Breaking bad news. Am Fam Physician. 2001;64(12):1975\u20138.","journal-title":"Am Fam Physician"},{"issue":"2","key":"8660_CR4","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1080\/08998280.2010.11928543","volume":"23","author":"RL Fine","year":"2010","unstructured":"Fine RL. Breaking bad news: communication skills for difficult conversations. Proc (Baylor Univ MedCent). 2010;23(2):138\u201341. https:\/\/doi.org\/10.1080\/08998280.2010.11928543.","journal-title":"Proc (Baylor Univ MedCent)."},{"issue":"11","key":"8660_CR5","doi-asserted-by":"publisher","first-page":"825","DOI":"10.1046\/j.1525-1497.2002.11100.x","volume":"17","author":"JD Orlander","year":"2002","unstructured":"Orlander JD, Fincke BG, Hermanns D, Johnson GA. Medical residents\u2019 first clearly remembered experiences of giving bad news. J Gen Intern Med. 2002;17(11):825\u201331. https:\/\/doi.org\/10.1046\/j.1525-1497.2002.11100.x.","journal-title":"J Gen Intern Med"},{"issue":"2","key":"8660_CR6","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1207\/s15327027hc1702_1","volume":"17","author":"WA Beach","year":"2005","unstructured":"Beach WA, Anderson JK. Communication and cancer: Examining residents\u2019 talk in difficult clinical situations. 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Oncologist. 2000;5(4):302\u201311. https:\/\/doi.org\/10.1634\/theoncologist.5-4-302.","journal-title":"Oncologist"},{"issue":"3","key":"8660_CR9","doi-asserted-by":"publisher","first-page":"707","DOI":"10.1093\/annonc\/mdt582","volume":"25","author":"C Seifart","year":"2014","unstructured":"Seifart C, Hofmann M, B\u00e4r T, Riera Knorrenschild J, Seifart U, Rief W. Breaking bad news\u2013what patients want and what they get: evaluating the SPIKES protocol in Germany. Ann Oncol. 2014;25(3):707\u201311. https:\/\/doi.org\/10.1093\/annonc\/mdt582.","journal-title":"Ann Oncol"},{"issue":"1","key":"8660_CR10","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1080\/08998280.2016.11929360","volume":"29","author":"KR Monden","year":"2016","unstructured":"Monden KR, Gentry L, Cox TR. Delivering bad news to patients. 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Am J Surg. 2001;182:20\u20133.","journal-title":"Am J Surg"}],"container-title":["BMC Medical Education"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12909-026-08660-7","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12909-026-08660-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12909-026-08660-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T17:05:01Z","timestamp":1781629501000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12909-026-08660-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,24]]},"references-count":17,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["8660"],"URL":"https:\/\/doi.org\/10.1186\/s12909-026-08660-7","relation":{},"ISSN":["1472-6920"],"issn-type":[{"value":"1472-6920","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,24]]},"assertion":[{"value":"26 October 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 January 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 January 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The Institutional Ethics Committee of the Mure\u0219 County Clinical Hospital in T\u00e2rgu Mure\u0219, Romania, granted ethical approval for this study (approval no. 3428\/04.03.2025). All participants provided informed consent; consent was implied by voluntary completion of the anonymous questionnaire. Participation was entirely voluntary.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"298"}}