Delivery of Difficult News Among Residents at a Tertiary Hospital In Kenya Using a Short Training Video (UNMASKES)

Document Type



Internal Medicine (East Africa); Brain and Mind Institute


Background: Delivery of difficult news (DDN) remains a challenging task for even the most experienced of providers. Little has been studied about delivery of difficult news among resident physicians in sub-Saharan Africa (SSA). We developed a 4-minute, graphic video using the acronym UNMASKES to help improve delivery of difficult news between resident physicians and their patients.

Objective: To determine the impact of the UNMASKES training video in improving resident communication when delivering difficult news.

Methods: We conducted a prospective study amongst all residents at the Aga Khan University hospital in Nairobi, Kenya and Dar es Salaam, Tanzania from February to September, 2019. After completing a pretest survey, residents received a one-hour comprehensive training on delivery of difficult news using UNMASKES. A link to the UNMASKES video was provided to the residents for real-time reference. Post-test surveys were completed at 4 and 12 weeks respectively.

Results: A total of 102 (68%) residents completed the surveys. At 12 weeks, we found that residents improved in 6 key areas; notified their patients before delivering difficult news, ensured a private and quiet room, provided information in small amounts to patients and family members, provided a summary after delivery of difficult news, followed up with patients at 24-48 hours after delivering difficult news, and felt better prepared to deal with patient and family emotions when delivering difficult news.

Conclusions: UNMASKES, a 4-minutes, easily accessible, graphic video showed promising results in training our residents to foster effective communication while delivering difficult news to their patients.

Publication (Name of Journal)