{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T18:00:05Z","timestamp":1790618405129,"version":"4.1.0"},"reference-count":82,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","award":["NIHR303738"],"award-info":[{"award-number":["NIHR303738"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Breaking bad news is a core component of emergency care, but the emergency department (ED) environment of urgency, crowding, and limited privacy presents challenges for sensitive communication. Many communication frameworks originate from other specialities, but the ED has limited evidence and guidance tailored to its context.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This scoping review aimed to map the extent, nature, and characteristics of the literature on delivery of bad news in EDs, including terminology, frameworks, stakeholder perspectives, barriers and facilitators, educational resources, reported metrics, and evidence gaps.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      The review followed Joanna Briggs Institute (JBI) methodology and was prospectively registered on the Open Science Framework (OSF\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/osf.io\/f6q59\/overview\" xlink:type=\"simple\">https:\/\/osf.io\/f6q59\/overview<\/jats:ext-link>\n                      ). Four databases (MEDLINE, EMBASE, EMCARE, CINAHL) and grey literature sources were searched in July 2025. Eligible sources included empirical studies, training evaluations, reviews, guidelines, consensus statements, editorials, commentaries, opinion pieces, educational articles, conference abstracts, and relevant grey literature reporting on adult patients, relatives, or clinicians in ED contexts. Data were charted and synthesised narratively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>From 7985 records, 156 publications were included. Studies originated from 26 countries, though the United States of America (USA) (n\u2009=\u200985) and United Kingdom (UK) (n\u2009=\u200918) dominated the literature. There was a rise in publications from 2010, particularly post\u2013COVID-19. Twenty-five communication frameworks were identified; most were adapted from oncology (with SPIKES most frequently cited). Three frameworks developed specifically for ED practice (GRIEV_ING, 8S, EMTalk) were identified. Stakeholder perspectives were unevenly represented, with a predominance of healthcare professional perspectives. Reported metrics centred on clinician confidence; patient- and family-centred studies were uncommon. Barriers to effective communication consistently included time scarcity, lack of privacy, and insufficient training.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec005\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Research on delivering bad news in EDs is dominated by educational and simulation-based studies, and is largely clinician-centred, with limited evidence of patient and family perspectives, with no studies examining long-term outcomes. Reliance on frameworks from other specialties risks overlooking the contextual specifics of emergency care. Future research should prioritise ED-centred frameworks, patient outcomes, and systemic enablers to support compassionate, effective communication in this demanding environment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0358343","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T17:25:56Z","timestamp":1790616356000},"page":"e0358343","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Understanding delivery of bad news in the emergency department: A scoping review"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6004-6244","authenticated-orcid":true,"given":"Graham","family":"Johnson","sequence":"first","affiliation":[{"name":"School of Social Sciences and Humanities, Loughborough University, Epinal Way","place":["Loughborough, United Kingdom"]},{"name":"School of Medicine, University of Nottingham, Queen\u2019s Medical Centre, East Block","place":["Nottingham, United Kingdom"]},{"name":"Royal Derby Hospital","place":["Derby, United Kingdom"],"department":["Emergency Department"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8966-5065","authenticated-orcid":true,"given":"Sarah","family":"Edwards","sequence":"additional","affiliation":[{"name":"Royal Derby Hospital","place":["Derby, United Kingdom"],"department":["Emergency Department"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather","family":"Jarman","sequence":"additional","affiliation":[{"name":"St George\u2019s University Hospitals NHS Foundation Trust","place":["London, United Kingdom"],"department":["Emergency Department Clinical Research Group"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Peel","sequence":"additional","affiliation":[{"name":"School of Social Sciences and Humanities, Loughborough University, Epinal Way","place":["Loughborough, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1571-5028","authenticated-orcid":true,"given":"Marco","family":"Pino","sequence":"additional","affiliation":[{"name":"School of Social Sciences and Humanities, Loughborough University, Epinal Way","place":["Loughborough, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,9,28]]},"reference":[{"issue":"5","key":"pone.0358343.ref001","doi-asserted-by":"crossref","first-page":"15","DOI":"10.7748\/en.2024.e2215","article-title":"Staff and patient experiences of crowding, corridor care and boarding: a rapid review","volume":"33","author":"S Robertson","year":"2024","journal-title":"Emergency Nurse"},{"issue":"3","key":"pone.0358343.ref002","first-page":"239","article-title":"Boarding in the emergency department: challenges and mitigation 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A review of the literature","volume":"276","author":"JT Ptacek","year":"1996","journal-title":"JAMA"},{"issue":"45","key":"pone.0358343.ref071","doi-asserted-by":"crossref","first-page":"51","DOI":"10.7748\/ns.28.45.51.e8935","article-title":"Breaking bad news: issues relating to nursing practice","volume":"28","author":"C Warnock","year":"2014","journal-title":"Nurs Stand"},{"issue":"1","key":"pone.0358343.ref072","doi-asserted-by":"crossref","first-page":"109","DOI":"10.2307\/2096409","article-title":"On \u201cRealization\u201d in everyday life: the forecasting of bad news as a social relation","volume":"61","author":"DW Maynard","year":"1996","journal-title":"American Sociological Review"},{"issue":"1","key":"pone.0358343.ref073","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1186\/s12955-020-01504-y","article-title":"Investigating the association between physicians self-efficacy regarding communication skills and risk of \u201cburnout\u201d","volume":"18","author":"A Messerotti","year":"2020","journal-title":"Health Qual Life Outcomes"},{"key":"pone.0358343.ref074","author":"S Berg"},{"key":"pone.0358343.ref075","article-title":"The impact of breaking bad news on oncologist burnout and how communication skills can help: a scoping review","volume":"10","author":"S Cheon","year":"2016","journal-title":"J Pain Manag"},{"key":"pone.0358343.ref076","doi-asserted-by":"crossref","first-page":"609","DOI":"10.3389\/fpsyt.2019.00609","article-title":"Posttraumatic stress disorder, depression, and prolonged grief disorder in families bereaved by a traumatic workplace death: the need for satisfactory information and support","volume":"10","author":"LR Matthews","year":"2019","journal-title":"Front Psychiatry"},{"issue":"6","key":"pone.0358343.ref077","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2024.15325","article-title":"Prevalence and co-occurrence of psychiatric conditions among bereaved adults","volume":"7","author":"AA Rheingold","year":"2024","journal-title":"JAMA Netw Open"},{"issue":"4","key":"pone.0358343.ref078","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1136\/emermed-2023-213189","article-title":"Perceived barriers and opportunities to improve working conditions and staff retention in emergency departments: a qualitative study","volume":"41","author":"J Daniels","year":"2024","journal-title":"Emerg Med J"},{"issue":"1","key":"pone.0358343.ref079","doi-asserted-by":"crossref","first-page":"890","DOI":"10.1186\/s12877-024-05429-9","article-title":"\u201cThe stay here is, of course, not appropriate for an old person\u201d: the perspective of healthcare providers on older patients in the emergency department","volume":"24","author":"J Deutschbein","year":"2024","journal-title":"BMC Geriatr"},{"key":"pone.0358343.ref080","doi-asserted-by":"crossref","first-page":"104706","DOI":"10.1016\/j.ijnurstu.2024.104706","article-title":"The association between nurse staffing and quality of care in emergency departments: a systematic review","volume":"153","author":"J Drennan","year":"2024","journal-title":"Int J Nurs Stud"},{"issue":"1","key":"pone.0358343.ref081","doi-asserted-by":"crossref","first-page":"1022","DOI":"10.1186\/s12909-025-07452-9","article-title":"A systematic multimodal assessment of AI machine translation tools for enhancing access to critical care education internationally","volume":"25","author":"CL Chen","year":"2025","journal-title":"BMC Med Educ"},{"issue":"1","key":"pone.0358343.ref082","first-page":"8","article-title":"Artificial intelligence and language translation in scientific publishing","volume":"47","author":"SF Gordon","year":"2024","journal-title":"Science Editor"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0358343","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T17:26:13Z","timestamp":1790616373000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0358343"}},"subtitle":[],"editor":[{"given":"Francesco","family":"De Vincenzo","sequence":"first","affiliation":[{"name":"European University of Rome: Universita Europea di Roma","place":["ITALY"]}],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,9,28]]},"references-count":82,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,9,28]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0358343","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,28]]}}}