MRCOG Part 3 Clinical Skills Intensive
Purchased separately Not included in subscriptionCurrent station
Continue Station 6
Breaking significant news: intrauterine fetal death · 30 min · 5 of 14 stations complete
Station 6 — Breaking significant news: intrauterine fetal death
Station block B · Breaking Significant News · 30 min · Faculty lead: Dr Helena Nwosu
Station brief
You are the registrar on the labour ward. Mrs Adaeze Nwankwo, a 32-year-old woman at 38+2 weeks gestation in her first pregnancy, has attended triage reporting reduced fetal movements over the preceding 18 hours. A bedside ultrasound performed by the on-call consultant has confirmed the absence of fetal cardiac activity. The consultant has asked you to go in and explain the findings to Mrs Nwankwo and her partner, who are currently in the assessment room and are not yet aware of the outcome.
You have 8 minutes with the role-players, followed by 2 minutes of examiner questions. There is no further clinical information to gather in this station — you should assume all investigations needed to confirm intrauterine death have already been completed and are available to you if asked for. This station assesses your ability to deliver significant news clearly and compassionately, and to outline appropriate next steps without overwhelming a couple who have just received devastating information.
Structured communication framework
Candidates are not marked on following a rigid script, but examiners consistently reward a recognisable structure. Use the framework below to organise your approach before you enter the room.
-
Prepare and set the scene
Confirm privacy, sit at the same level as the couple, remove distractions such as notes or a bleep, and confirm who is present and their relationship to the patient.
-
Establish what she already knows
Ask an open question before delivering any information — for example, what she understands so far and why she has come in — to judge her current understanding and readiness to hear news.
-
Deliver a warning shot, then the news
Use a brief warning statement ("I'm afraid I have some very sad news") before the diagnosis, then state it plainly — "there is no heartbeat" — avoiding euphemism, jargon or excessive detail at this point.
-
Allow silence and respond to emotion
Pause. Let the news land before continuing. Acknowledge distress explicitly and respond to emotional cues with empathy before moving on to practical information.
-
Explain next steps and safety-net
Outline the options for birth, offer bereavement midwife and chaplaincy support, agree an immediate plan, and check understanding before you close the consultation.
Examiner feedback resources
Part 3 stations are marked against three assessment domains. The descriptors below mirror the language used on the Station 6 mark sheet, so you can self-assess a recorded attempt against the same criteria an examiner would apply.
| Domain | Descriptor | Marks available |
|---|---|---|
| Information gathering | Establishes what the couple already know and their readiness to hear news before delivering the diagnosis. | 0–4 |
| Communication with patients and families | Delivers the diagnosis clearly and sensitively, avoids jargon and euphemism, allows silence, and responds appropriately to emotional cues. | 0–8 |
| Applied clinical knowledge | Outlines appropriate next steps — mode of birth, investigations, bereavement support pathway — accurately and at a level the couple can absorb. | 0–4 |