Background:
Delivering bad news in oncology is one of the most emotionally charged and complex tasks in clinical practice. Recognizing the urgent need for compassionate, structured communication, the Costa Rican Social Security System (CCSS) launched in 2023 a national interdisciplinary training program for healthcare professionals involved in cancer care.
Objective:
To strengthen communication competencies through evidence-based strategies that enable empathetic, clear, and patient-centered delivery of serious news in oncology.
Methods:
The course was collaboratively developed by oncologists, palliative care specialists, and psycho-oncologists, and has been delivered annually. It consists of three consecutive full-day sessions combining didactic lectures, clinical case discussions, role-playing with simulated patients, and interdisciplinary roundtables. Topics include diagnostic disclosure, discussing prognosis, handling difficult emotions, communicating recurrence or treatment failure, shared decision-making, and end-of-life conversations. Cultural, cognitive, and social diversity are considered throughout the curriculum.
Framework:
The course is inspired by internationally recognized programs such as the Comskil Training Program at Memorial Sloan Kettering Cancer Center. It integrates theoretical, ethical, and practical components, supported by key publications (e.g., Kissane et al., 2012; Bylund et al., 2011; Banerjee et al., 2021) that demonstrate improved patient-provider communication, enhanced empathy, and better clinical outcomes.
Results:
Since its implementation, the training has been well-received by multidisciplinary teams across the country. Participants report greater confidence and preparedness in conducting challenging conversations. The course has fostered interprofessional collaboration and established a replicable model for other public health systems.
Conclusion:
This Costa Rican initiative highlights the feasibility and impact of implementing a high-quality communication training program in a public healthcare context. It contributes to a more humanized, ethical, and effective oncology care approach aligned with international psycho-oncology standards.