Learning through difficult disclosures of cancer progression: experiences of physicians and nurses in training

Objective: Breaking the news of cancer progression is a complex task that requires a balance between clinical accuracy and relational sensitivity. Although research has examined the perspectives of experienced healthcare professionals, little is known about how trainees navigate these consultations. This study aims to explore the experiences of medical and nursing trainees in disclosing disease progression, focusing on communication strategies, emotional impacts, and professional development. Methods: Eighteen semi-structured interviews were conducted with trainees in Swiss hospitals (11 oncologists and 7 nurses). The data were analyzed via thematic analysis. Results: Five themes emerged: professional role perceptions and oncology practices in cancer progression care , the process of disclosing disease progression , perceptions and reactions of patients and their family caregivers, impacts of disease progression disclosure on medical and nursing trainees, and training and development of communication skills . Participants reported developing these skills through experiential learning, noting that formal training and protocols offered limited support. They portrayed disclosure as a carefully prepared, emotionally demanding process that requires clarity, empathy, and teamwork. Trainees described emotional and organizational burdens, which they felt were eased by experience and peer support. Furthermore, they highlighted the variability in patient and family caregiver reactions, which influenced decision-making and underscored the need for flexible, relationally attuned communication. Conclusion: Disclosing cancer progression is a demanding experience for trainees, who described the need to adapt their communication, manage emotional responses, and rely on interprofessional collaboration. Their accounts highlight the central role of experience, supervision, and supportive environments in shaping how they navigate these challenging consultations.