Article Text

Download PDFPDF
Time-critical telephone conversations in the emergency department: lessons learnt from a pilot educational project to improve communication skills over the telephone in response to the COVID-19 global pandemic
  1. Sarah Edwards1,
  2. Lisa Keillor1,2,
  3. Lorna Sandison1,3,
  4. Abigail Millett1,
  5. Ffion Davies1
  1. 1 Emergency Department, Infirmary Square, University Hospitals of Leicester NHS Trust, Leicester, UK
  2. 2 Emergency Department, Queen's Medical Centre, Nottingham, UK
  3. 3 Emergency Department, Kettering General Hospital, Kettering, UK
  1. Correspondence to Dr Sarah Edwards, Emergency Department, Infirmary Square, University Hospitals of Leicester NHS Trust, Leicester, LE1 5WW, UK; drsarahedwards{at}


In many countries, the COVID-19 pandemic resulted in restricted hospital visiting by relatives.

Staff have been forced to deliver unwelcome and bad news over the telephone. There are few training resources around how to do this. We created a bespoke training package consisting of a 15 min eLearning session and a 1-hour facilitated role-play session. Two simulated telephone calls to a professional actor posing as the relative were undertaken on a speakerphone. Following each simulated call, the actor gave feedback to the caller, focusing on the likely experience of a relative during these conversations. Elements specific to telephone conversations included ensuring the safety of the recipient to take the call (eg, not driving a car), ensuring they had adequate local support, and allowing a deliberate silence after delivering the bad news. Silence has a powerful impact, despite being uncomfortable. The opportunity to have written notes before calling and to offer a return call was seen as an opportunity for improving communication. We collated these experiences into a series of phrases found most useful and empathic by the actor and participants. A practical aide- mémoir was created from this learning that could be used to help deliver bad news quickly in the emergency department.

  • education
  • COVID-19
  • teaching
  • death

Data availability statement

Available on request.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Data availability statement

Available on request.

View Full Text


  • Handling editor Ellen J Weber

  • Twitter @drsarahedwards, @drlisyloo, @LornaSandison, @FfionDavies4

  • Contributors All authors have been involved in setting up and delivering this training. SE and LK wrote the paper. LS, FD and AM have helped to edit the paper.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.