Original Publication
Open Access

Delivering The News With Compassion: The GRIEV_ING Death Notification Protocol

Published: August 3, 2010 | 10.15766/mep_2374-8265.8210

Included in this publication:

  • Trainer's Manual Cover.doc
  • Table of Contents.doc
  • Rationale.doc
  • Schedule.doc
  • How To Use These Materials.doc
  • Appendix A and C PowerPoint.ppt
  • Appendix B Facilitator's Discussion Guide.doc
  • Appendix D Role Plays Instructions Scenarios.doc
  • Appendix E Guidelines Training Standardized Patients.doc
  • Appendix F Self-Efficacy Survey.doc
  • Appendix G GRIEVING Competence Instrument.doc
  • Appendix H Relationship Communication Instrument.doc

To view all publication components, extract (i.e., unzip) them from the downloaded .zip file.

Editor's Note: This publication predates our implementation of the Educational Summary Report in 2016 and thus displays a different format than newer publications.


Introduction: Nearly 2.4 million deaths occur annually, over a million of which take place in hospitals. As a result, death notification remains a daunting and emotionally challenging task that physicians encounter throughout their careers. However, in one study, fewer than half of all physicians reported receiving death notification education in medical school or residency, while in another, 94% reported that such education is needed. Nevertheless, no validated educational interventions exist that are specifically designed to teach medical students, residents, and fellows effective skills in death notification that can be implemented in a practical time frame and allow easy integration into busy schedules. To address this need, a 2-hour-long educational intervention based on the GRIEV_ING Death Notification Protocol was developed and validated. The intervention provides a complete teaching and learning module composed of small-group, role-play, and didactic experiences to train residents and medical students in effective death notification skills. Methods: This resource is a comprehensive teaching and learning module designed to provide educators with practical, proven teaching and assessment tools to help residents and medical students develop confidence and competence in death notification. The resource includes a PowerPoint presentation that provides training on the GRIEV_ING mnemonic, as well as documents that detail small-group activities in the form of structured discussions and role-plays to facilitate interactive learning. The resource also includes a self-efficacy survey, detailed standardized survivor scenarios, and assessment tools such as a Relationship and Communication Instrument and the GRIEV_ING Competence Instrument to help gauge progress. Results: In one study, 20 residents significantly improved and retained their confidence and competence in death notification following exposure to this intervention. In another study, all 138 fourth-year medical students who were exposed to this intervention improved their overall competence and self-confidence in death notification. In addition, students who were exposed to a simulated survivor and provided feedback on their performance, in addition to being taught the GRIEV_ING protocol, improved their competence and confidence significantly. Discussion: The significance of this resource is that it addresses an important educational need by providing practical, proven, and effective teaching and assessment tools to help students learn effective death notification skills.

Educational Objectives

Use of this module will:

  1. Provide educators practical, proven teaching and assessment tools for death notification.
  2. Develop proficiency of residents, medical students, and fellows in effective death notification skills.
  3. Measure and improve confidence and competence in death notification through participation in an interactive teaching and learning module based on the GRIEV_ING mnemonic.

Author Information

  • Cherri Hobgood, MD: University of North Carolina at Chapel Hill School of Medicine
  • Joey Woodyard: UNC School of Medicine
  • Susan Sawning: UNC School of Medicine
  • Katherine Savage: UNC School of Medicine

None to report.

None to report.


  1. Hobgood, C., Harward, D., Newton, K., & Davis, W. (2005). The educational intervention "GRIEV_ING" improves the death notification skills of residents. Academic Emergency Medicine, 12(4), 296-301. http://dx.doi.org/10.1111/j.1553-2712.2005.tb01943.x
  2. Hobgood, C. D., Tamayo-Sarver, J. H., Hollar Jr, D. W., & Sawning, S. (2009). GRIEV_ING: Death notification skills and applications for fourth-year medical students. Teaching and Learning in Medicine,21(3), 207-219. http://dx.doi.org/10.1080/10401330903018450


Hobgood C, Woodyard J, Sawning S, Savage K. Delivering the news with compassion: the GRIEV_ING death notification protocol. MedEdPORTAL. 2010;6:8210. https://doi.org/10.15766/mep_2374-8265.8210