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December 11, 1996

Delivering Bad News-Reply

Author Affiliations

Bucknell University Lewisburg, Pa

JAMA. 1996;276(22):1802. doi:10.1001/jama.1996.03540220026020

In Reply.  —The thoughtful comments made by the authors of the letters in response to our article prompted several thoughts of our own. First, it was encouraging to be provided with information about the apparently effective use of SPs in the training of medical personnel. Such an approach will be most effective when integrated with other training experiences that help explicate the personal, interpersonal, and institutional processes that make bad news transactions potentially problematic for giver and receiver. Without this integration, trainees may be left with a heightened sense of anxiety, as they recognize that such transactions are important enough to warrant a workshop, but have an insufficient theoretical or social context in which to place their new skills. More detailed aspects of various training programs also have been reported.1-2Second, some evidence suggests that for certain medical conditions, such as cancer, social support can have lasting positive effects.3 Conversely,