ArticlePloS one2026
Understanding delivery of bad news in the emergency department: A scoping review.
Article in PloS one, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundBreaking 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.
objectiveThis 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.
methodsThe review followed Joanna Briggs Institute (JBI) methodology and was prospectively registered on the Open Science Framework (OSF https://osf.io/f6q59/overview). 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.
resultsFrom 7985 records, 156 publications were included. Studies originated from 26 countries, though the United States of America (USA) (n = 85) and United Kingdom (UK) (n = 18) dominated the literature. There was a rise in publications from 2010, particularly post-COVID-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.
conclusionsResearch 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.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.