The Breaking bad news Assessment Schedule (BAS) is a method of evaluating how well a physician breaks bad news to patients. It consists of 23 items divided into 5 subject areas. It was developed in Oxford, England.


Subject Areas:

(a) Setting the Stage: This section looks at whether the doctor facilitated an initial rapport before breaking the bad news.

(b) Breaking the News: This section specifically focuses on whether the doctor was sensitive to the patient's perspective when he/she delivered the news.

(c) Eliciting Concerns: This section focuses on whether the doctor actively attempted to gain a clear idea of the personal implications and meaning of the news to the patient, and the concerns that it generated.

(d) Information Giving: This sections looks at aspects other than giving the news itself.

(e) General Considerations: These points relate to the interview as a whole.


A. Setting the Stage: 3 items


B. Breaking the News: 5 items


C. Eliciting Concerns: 3 items


D. Information Giving: 4 items


E. General Considerations: 8 items


Graded Responses:

• range from 1 to 5, with 1 "poor" and 5 "very well"

• wording "very well" to "poorly": 1, 23

• wording "definitely" to "not at all": 2, 3, 5, 6, 7, 8, 9, 10, 13, 14, 20, 22

• wording "carefully" to "not at all": 4, 11

• wording "entirely" to not at all: 12

• wording "always" to "frequently inaccurate: 15

• wording "all ten" to "none at all": 16

• wording "all of them" to "none at all": 17

• wording "fully" to "not at all": 18

• wording "always" to "not at all": 19

• wording "never clumsy" to "often clumsy": 21


Breaking bad news Assessment Score =

= SUM(points for all 23 items)



• minimum score: 23

• maximum score: 115

• The higher the score, the better the handling of bad news delivery.


The behavior of the physician for each item can be described based on 2 to 6 features.


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